Reduced-intensity non-T-cell depleted HLA-haploidentical stem cell transplantation for older patients based on the concept of feto-maternal tolerance.
Bone Marrow Transplant
; 34(10): 897-9, 2004 Nov.
Article
en En
| MEDLINE
| ID: mdl-15361902
With the recent progress in reduced-intensity conditioning stem cell transplantation (RIST) and taking into consideration the concept of feto-maternal immunological tolerance, we carried out non-T-cell depleted HLA haploidentical RIST from noninherited maternal antigen (NIMA) complementary siblings or offspring donors for four older patients: a patient with myeloplastic syndrome (MDS) and three patients with adult T-cell leukemia (ATL) in partial remission or with progressive disease. All patients showed early, durable engraftment, and no serious toxicities were observed apart from grade III mucositis in one case. Grade II acute GVHD occurred in two cases, which was well-controlled. In one ATL patient whose donor did not have NIMA microchimerism, tacrolimus could not be continued after engraftment due to renal dysfunction, and grade III acute GVHD (gut: stage 4) occurred on day 35. A patient with MDS was free from disease (requiring no transfusions and with a normal bone marrow) for 15 months. Two cases of ATL relapsed. Feto-maternal tolerance may lead to new RIST strategies in the haploidentical reduced-intensity situation, but further evaluation is required.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Prueba de Histocompatibilidad
/
Trasplante de Células Madre Hematopoyéticas
/
Acondicionamiento Pretrasplante
/
Tolerancia al Trasplante
Límite:
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Bone Marrow Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2004
Tipo del documento:
Article
País de afiliación:
Japón
Pais de publicación:
Reino Unido