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Graft Manipulation

Haploidentical HCT using an αβ T-cell-depleted graft with targeted αβ+ cells by add-back after a reduced intensity preparative regimen containing low-dose TBI

Bone Marrow Transplantation volume 51, pages 1217–1222 (2016)Cite this article

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Abstract

Between 2012 and 2015, 42 pediatric patients underwent haploidentical hematopoietic cell transplantation using an αβ+ T-cell-depleted graft with targeted αβ cells at 1–5 × 105/kg by add-back; 31 had hematologic malignancy (HM), 8 had non-malignant disease (NM) and 3 had solid tumors. All patients received uniform reduced-intensity conditioning with fludarabine, cyclophosphamide, rabbit anti-thymocyte globulin and low-dose TBI. All 42 patients achieved neutrophil engraftment at a median of 10 days. The cumulative incidences (CIs) of ⩾grade II and ⩾grade III acute GvHD were 31±7.1% (SE) and 12±5.0%, respectively, and 1-year CI of chronic GvHD was 15±5.8%. One patient died of CMV pneumonia, leading to transplant-related mortality (TRM) of 2.6±2.5%. Sixteen patients relapsed and 11 died of disease. At a median follow-up of 19 months (range, 5–43 months), the estimated 2-year event-free survival for NM and HM were 88±11.7 and 50±10.1%, respectively. Our study demonstrated that haploidentical hematopoietic cell transplantation after ex vivo depletion of αβ+ T cells with targeted dose noticeably reduced the graft failure rate and TRM in pediatric patients and could be applied to patients lacking a suitable related or unrelated donor.

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Acknowledgements

This study was supported by a grant (2012–0829) from the Asan Institute for Life Sciences, Seoul, Korea.

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Authors and Affiliations

  1. Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

    H J Im, K N Koh, J K Suh, S W Lee, E S Choi & J J Seo

  2. Department of Laboratory Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

    S Jang, S W Kwon & C-J Park

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  1. H J Im
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Correspondence to H J Im.

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Im, H., Koh, K., Suh, J. et al. Haploidentical HCT using an αβ T-cell-depleted graft with targeted αβ+ cells by add-back after a reduced intensity preparative regimen containing low-dose TBI. Bone Marrow Transplant 51, 1217–1222 (2016). https://doi.org/10.1038/bmt.2016.114

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