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Sirolimus in unmanipulated haploidentical cell transplantation

Bone Marrow Transplantation volume 42, pages 765–766 (2008)Cite this article

Haploidentical hematopoietic transplantation represents a curative option for certain patients with advanced hematological neoplasms.1, 2 T-cell depletion or post-transplant CY abrogates risks of GVHD but may impair engraftment, post-transplant immune reconstitution or graft-versus-tumor effects.3, 4, 5 We incorporated the immunosuppressive sirolimus into a nonmyeloablative regimen for T-cell replete transplantation of haplotype-mismatched progenitor cells in 17 patients without other suitable donors.

Fludarabine (25 mg/m2) was administered i.v. from days −7 to −3 (five total doses) and CY (1000 mg/m2) was administered i.v. on days −7 and −6. Sirolimus was administered on day −7 and tacrolimus on day −4 (both at 5–10 ng/ml). Tacrolimus was continued until at least day 30 and sirolimus until at least day 100. Equine anti-thymocyte globulin (30 mg/m2) (with methylprednisolone premedication) was given on days −1, +1, +3 and +5 and MTX (5 mg/m2) was administered i.v. on days +1, +3 and +6. Haploidentical (3 or 4/6 HLA antigens matching) G-CSF-mobilized progenitor cells were infused unmanipulated.

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  1. Division of Hematology and Oncology, Penn State Hershey Cancer Institute, The Penn State Milton S. Hershey Medical Center, Herschey, PA, USA

    L von Reyn Cream, W C Ehmann, W B Rybka & D F Claxton

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  1. L von Reyn Cream
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  2. W C Ehmann
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  3. W B Rybka
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  4. D F Claxton
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Correspondence to D F Claxton.

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von Reyn Cream, L., Ehmann, W., Rybka, W. et al. Sirolimus in unmanipulated haploidentical cell transplantation. Bone Marrow Transplant 42, 765–766 (2008). https://doi.org/10.1038/bmt.2008.242

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