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Outcomes of salvage haploidentical transplantation using posttransplant cyclophosphamide for graft failure following allogeneic hematopoietic stem cell transplantation.
Harada, Kaito; Najima, Yuho; Kato, Motohiro; Fuji, Shigeo; Shinohara, Akihito; Nakamae, Hirohisa; Toyosaki, Masako; Ashiarai, Miho; Onizuka, Makoto; Hashii, Yoshiko; Ichinohe, Tatsuo; Atsuta, Yoshiko; Nakasone, Hideki.
Afiliación
  • Harada K; Department of Hematology and Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1143, Japan. k.harada@tsc.u-tokai.ac.jp.
  • Najima Y; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
  • Kato M; Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan.
  • Fuji S; Department of Hematology, Osaka International Cancer Institute, Osaka, Japan.
  • Shinohara A; Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.
  • Nakamae H; Department of Hematology, Osaka City University Hospital, Osaka, Japan.
  • Toyosaki M; Department of Hematology and Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1143, Japan.
  • Ashiarai M; Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan.
  • Onizuka M; Department of Hematology and Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1143, Japan.
  • Hashii Y; Cancer Immunotherapy/Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
  • Ichinohe T; Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
  • Atsuta Y; Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
  • Nakasone H; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan.
Int J Hematol ; 116(5): 744-753, 2022 Nov.
Article en En | MEDLINE | ID: mdl-35767142
Haploidentical donors have emerged as an alternative donor source for salvage stem cell transplantation (SCT) after graft failure; however, data regarding salvage haploidentical SCT using posttransplant cyclophosphamide (PTCy) are limited. Using nationwide data (2011-2019), we retrospectively investigated transplant outcomes after salvage haploidentical SCT using PTCy for graft failure (n = 33, median age 34 years). The total dose of PTCy was 75-100 mg/kg (standard dose) in 26 patients (78.8%) and 40-50 mg/kg (lower dose) in 5 patients (15.2%). The neutrophil engraftment rate at 30 days was 81.8%. One-year overall survival (OS) and non-relapse mortality (NRM) rates were 47.4% and 46.0%, respectively. The standard-dose group exhibited better OS (61.1% vs. 0.0% at 1 year, P = 0.022) and NRM (35.1% vs. 80.0% at 1 year, P = 0.052) than the lower-dose group. Moreover, the standard-dose group was less prone to both grades II-IV (11.5% vs. 40.0%) and III-IV (0.0% vs. 40.0%) acute graft-versus-host disease (GVHD). Use of cyclophosphamide in previous SCT and conditioning did not affect OS or NRM. In conclusion, haploidentical salvage SCT using PTCy offers promising survival outcomes. Prospective studies are required to validate the efficacy of salvage haploidentical SCT using PTCy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Células Madre Hematopoyéticas / Trasplante Haploidéntico Tipo de estudio: Observational_studies Límite: Adult / Humans Idioma: En Revista: Int J Hematol Asunto de la revista: HEMATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Células Madre Hematopoyéticas / Trasplante Haploidéntico Tipo de estudio: Observational_studies Límite: Adult / Humans Idioma: En Revista: Int J Hematol Asunto de la revista: HEMATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón