Tumorablative conditioning regimen for haploidentical stem cell transplantation in 102 children with hematologic malignancies: a single-center experience
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Luo Rongmu1,2,3, Zhang Xiaomei1,2,3, Du Zhenlan1,2,3, Wang Ya1,2,3, Chen Wei1,2,3, Si Yingjian1,2,3, Gu Wenjing1,2,3, Xing Guosheng1,2,3, Wang Yang1,2,3 and Da Wanming1,4
1Affiliated BaYi Children’s Hospital, PLA Army General Hospital, Beijing, China
2National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
3Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
4Department of Hematology, Chinese PLA General Hospital, Beijing, China
Da Wanming, email: [email protected]
Luo Rongmu, email: [email protected]
Keywords: conditioning; haploidentical; hematopoietic stem cell transplantation; hematologic malignancy; graft-versus-host disease
Received: August 21, 2017 Accepted: November 13, 2017 Published: December 04, 2017
Haploidentical hematopoietic stem cell transplantation (Haplo-HSCT) is widely carried out in China, and transplantation related complications decreased gradually with the transplant technology improving, and the overall survival(OS) increased year by year. However, relapse after transplantation is still one of the main causes of death in patients with hematological malignancy. In order to reduce the recurrence after HSCT, we set a tumorablative conditioning regimen (TAC ) regimen; the aim is as much as possible to eliminate the malignant clone to reduce the recurrence without increasing the conditioning toxicity. We retrospectively analyzed 102 cases of haplo-HSCT in our hospital from 2012 to 2017. Ninety-eight out of the 99 (99.0%) patients achieved primary engraftment. The 2-year OS and disease free survival (DFS) are 81.4% (83/102) and 77.45% (79/102). The cumulative incidence of leukemia relapse is 16.2% (16/99), Twenty-nine patients developed II-IV acute graft-versus-host disease (aGVHD) (29%) within 100 days and only nine patients have grade III-IV aGVHD (9%) in measurable 99 patients. The conditioning regimen was relatively well tolerated with limited regimen-related toxicity. The preliminary results show that TAC is safe and effective in haplo-HSCT of children with hematologic malignancies. This study will provide a clinical basis for the individualized conditioning regimen.
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