Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Allografting

HLA-haploidentical hematopoietic SCT from collateral related donors without in vitro T-cell depletion for hematological malignancies

Bone Marrow Transplantation volume 49, pages 496–501 (2014)Cite this article

Subjects

Abstract

HLA-haploidentical hematopoietic SCT (HSCT) provides an opportunity for almost all patients who lack HLA-matched sibling donors. The donor availability can be increased by including the collateral related donors (CRDs). We compared clinical outcomes of patients with hematological malignancies, who underwent haploidentical HSCT from CRD (n=30) and immediate related donors (IRDs; n=120). In CRDs, 29 (96.7%) patients achieved sustained engraftment. In CRDs and IRDs, the median times of myeloid recovery were 13 (range 10–20 days) and 14 days (range 12–23 days), and the median times of platelet recovery were 18 (range 7–270) and 15 days (range 7–132 days; P=0.027). The incidences of II–IV acute GVHD were 27.6% versus 39.4% (P=0.058). The 2-year cumulative incidences of chronic GVHD (cGVHD) were 63.3% versus 57.8% (P=0.365). The 2-year incidence of extensive cGVHD of CRDs was significantly higher than that of IRDs (36.7% versus 20.2%, P=0.03). The 2-year incidences of relapse, 3-year probability of OS and leukemia-free survival for the two groups were 26.7% versus 14.8% (P=0.17), 56.7% versus 70.4% (P=0.224) and 50.0% versus 65.4% (P=0.103), respectively. This study shows that haploidentical HSCT from CRDs can provide a safe and effective treatment for patients with hematological malignancies. CRDs could be an alternative when there was no suitable IRDs.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6

Similar content being viewed by others

References

  1. Ruggeri L, Capanni M, Casucci M, Volpi I, Tosti A, Perruccio K et al. Role of natural killer cell alloreactivity in HLA-mismatched hematopoietic stem cell trasplantation. Blood 1999; 94: 333–339.

    CAS  PubMed  Google Scholar 

  2. Ruggeri L, Capanni M, Urbani E, Perruccio K, Shlomchik WD, Tosti A et al. Effectiveness of donor natural killer cell alloreactivity in mismatched hematoopoietic transplants. Science 2002; 295: 2097–2100.

    Article  CAS  PubMed  Google Scholar 

  3. Huang XJ, Liu DH, Liu KY, Xu LP, Chen H, Han W et al. Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies. Bone Marrow Transplant 2006; 38: 291–297.

    Article  PubMed  Google Scholar 

  4. Lu DP, Dong L, Wu T, Huang XJ, Zhang MJ, Han W et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation. Blood 2006; 107: 3065–3073.

    Article  CAS  PubMed  Google Scholar 

  5. Huang XJ, Liu DH, Liu KY, Xu LP, Chen H, Han W et al. Treatment of acute leukemia with unmanipulated HLA-mismatched/haploidentical blood and bone marrow transplantation. Biol Blood Marrow Transplant 2009; 15: 257–265.

    Article  CAS  PubMed  Google Scholar 

  6. Huang XJ, Xu LP, Liu KY, Liu DH, Chen H, Han W et al. HLA-mismatched/haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for chronic myeloid leukemia:improved outcomes in patients in accelerated phase and blast crisis phase. Ann Med 2008; 40: 444–455.

    Article  CAS  Google Scholar 

  7. Liu DH, Huang XJ, Liu KY, Xu LP, Chen H, Han W et al. Haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for treatment of hematological malignancies in children. Biol Blood Marrow Transplant 2008; 14: 469–477.

    Article  CAS  PubMed  Google Scholar 

  8. Huang XJ, Xu LP, Liu KY, Liu DH, Wang Y, Chen H et al. Partially matched related donor transplantation can achieve outcomes comparable with unrelated donor transplantation for patients with hematologic malignancies. Clin Cancer Res 2009; 15: 4777–4783.

    Article  CAS  Google Scholar 

  9. Chen YH, Liu KY, Xu LP, Chen H, Liu DH, Zhang XH et al. HLA-mismatched hematopoietic SCT without in vitro T-cell depletion for myelodysplastic syndrome. Bone Marrow Transplant 2010; 45: 1333–1339.

    Article  CAS  PubMed  Google Scholar 

  10. Thomas ED, Storb R, Clift RA, Fefer A, Johnson L, Neiman PE et al. Bone marrow transplantation (second of two parts). N Engl J Med 1975; 292: 895–902.

    Article  CAS  PubMed  Google Scholar 

  11. Shulman HM, Sullivan KM, Weiden PL, McDonald GB, Striker GE, Sale GE et al. Chronic graft-versus-host syndrome in man: a long-term clinicopathologic study of 20 Seattle patients. Am J Med 1980; 69: 204–217.

    Article  CAS  PubMed  Google Scholar 

  12. Huang XJ, Liu DH, Liu KY, Xu LP, Chen H . HanW.Donor lymphocyte infusion for the treatment of leukemia relapse after HLA-mismatched/haplo-identical T-cell-replete hematopoietic stem cell transplantation. Haematologica 2007; 92: 414–417.

    Article  PubMed  Google Scholar 

  13. Huret JL, Minor SL, Dorkeld F, Dessen P, Bernheim A . Atlas of genetics and cytogenetics in oncology and haematology,an interactive database. Nucleic Acids Res 2000; 28: 349–351.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Mehta J, Singhal S, Gee AP, Chiang KY, Godder K, Rhee Fv F et al. Bone marrow transplantation from partially HLA-mismatched family donors for acute leukemia:single-center experience of 201 patients. Bone Marrow Transplant 2004; 33: 389–396.

    Article  CAS  PubMed  Google Scholar 

  15. Aversa F, Terenzi A, Tabilio A, Falzetti F, Carotti A, Ballanti S et al. Full-haplotype mismatched hematopoietic stem cell transplantation: a phase II study in patients with acuteleukemia at high risk or relapse. J Clin Oncol 2005; 23: 3447–3454.

    Article  PubMed  Google Scholar 

  16. Anasetti C, Amos D, Beatty PG, Appelbaum FR, Bensinger W, Buckner CD et al. Effect of HLA compatibility on engraftment of bone marrow transplants in patients with leukemia or lymphoma. N Engl J Med 1989; 320: 197–204.

    Article  CAS  PubMed  Google Scholar 

  17. Anasetti C, Beatty PG, Storb R, Martin PJ, Mori M, Sanders JE et al. Effect of HLA incompatibility on graft-versus -host disease, relapse, and survival after marrow transplantation for patients with leukemia or lymphoma. Hum Immunol 1990; 29: 79–91.

    Article  CAS  PubMed  Google Scholar 

  18. Rizzieri DA, Koh LP, Long GD, Gasparetto C, Sullivan KM, Horwitz M et al. Partially matched, nonmyeloablative allogeneic transplantation: clinical outcomes and immune reconstitution. J Clin Oncol 2007; 25: 690–697.

    Article  CAS  PubMed  Google Scholar 

  19. Luo XH, Chang YJ, Xu LP, Liu DH, Liu KY, Huang XJ . The impact of graft composition on clinical outcomes in unmanipulated HLA-mismatched/haploidentical hematopoietic SCT. Bone Marrow Transplant 2009; 43: 29–36.

    Article  CAS  PubMed  Google Scholar 

  20. Chang YJ, Zhao XY, Huo MR, Xu LP, Liu DH, Liu KY et al. Influence of lymphocyte recovery on outcome of haploidentical transplantation for hematologic malignancies. Medicine 2009; 88: 322–330.

    Article  PubMed  Google Scholar 

  21. Aversa F, Tabilio A, Velardi A, Cunningham I, Terenzi A, Falzetti F et al. Treatment of high risk acute leukemia withT cell-depleted stem cells from related donors with one fully mismatched HLA haplotype. N Engl J Med 1998; 339: 1186–1193.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by the National Clinical Key Specialties of China, the National Natural Science Foundation of China (grant number: 30971292) and Beijing Natural Science Foundation (grant number: 7122193).

Author information

Authors and Affiliations

  1. Beijing Key Laboratory, Institute of Hematology, Peking University People’s Hospital, Beijing, China

    Y-y Zhang, D-h Liu, K-y Liu, L-p Xu, H Chen, W Han, Y Wang & X-j Huang

Authors
  1. Y-y Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D-h Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K-y Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L-p Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. W Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Y Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. X-j Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to X-j Huang.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhang, Yy., Liu, Dh., Liu, Ky. et al. HLA-haploidentical hematopoietic SCT from collateral related donors without in vitro T-cell depletion for hematological malignancies. Bone Marrow Transplant 49, 496–501 (2014). https://doi.org/10.1038/bmt.2013.223

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2013.223

Keywords

This article is cited by

Search

Advanced search

Quick links