T-cell depletion of an HLA-haploidentical (haplo) graft is often used to reduce the risk of graft-versus-host disease (GVHD), but the lack of donor T cells in the infused product may lead to graft failure, slow T-cell reconstitution, infections, and relapse. More selective T-cell depletion targeting CD45RA can effectively deplete naive T cells but preserve large numbers of memory T cells leading to robust engraftment of diverse T-cell populations and reduction of viremia in the early posttransplant period. Herein, we report the outcome of 143 pediatric and young adult hematologic malignancy patients receiving a first allogeneic hematopoietic cell transplantation (HCT) on six consecutive ex vivo T-cell depleted haploHCT protocols over the past 15 years at a single institution-including the first 50 patients on an active CD45RA-depleted haploHCT study in which patients also received NK-cells and pharmacological GvHD prophylaxis post transplant. Our data demonstrated an increase in the 3-year overall survival and event-free survival in nonchemorefractory recipients receiving CD45RA-depleted grafts (78.9% and 77.7%, respectively) compared with historic T-cell depleted haploHCT cohorts (46.7% and 42.7%, respectively, p = 0.004, and 0.003). This improvement was primarily due to a reduction in transplant related mortality without significant increase in the rates of GVHD.

中文翻译：

---

在过去的15年中，在单个机构中提高了T细胞耗竭的单倍型造血细胞移植的存活率。

经常使用HLA单倍型（haplo）移植物的T细胞耗竭来降低移植物抗宿主病（GVHD）的风险，但是输注产品中缺乏供体T细胞可能导致移植物衰竭，T缓慢细胞重构，感染和复发。靶向CD45RA的更具选择性的T细胞耗竭可以有效耗竭幼稚T细胞，但保留大量记忆T细胞，从而导致在移植后的早期牢固植入各种T细胞群体并降低病毒血症。在此处，我们报告了过去15年中在一家机构中连续六次连续的T细胞耗尽haploHCT方案接受了第一次同种异体造血细胞移植（HCT）的143例小儿和年轻成人血液系统恶性肿瘤患者的结果-包括首批50例一项活跃的CD45RA耗竭型haploHCT研究，患者在移植后还接受了NK细胞和GvHD的药理学预防。我们的数据表明，与以往的T细胞耗竭型单倍型HCT人群（分别为46.7％和42.7％， p = 0.004和0.003）。