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.

  • Letter to the Editor
  • Published:

Haploidentical bone marrow transplantation with post-grafting cyclophosphamide: multicenter experience with an alternative salvage strategy

Leukemia volume 25, pages 880–883 (2011)Cite this article

Subjects

Achieving a cure for relapsed leukemia or lymphoma remains a challenge. Allogeneic stem cell transplantation (aSCT) after myeloablative conditioning is a curative treatment option for younger patients. However, concerns regarding aSCT-related toxicity and questions regarding the overall benefit, limit its use for older patients and for heavily pre-treated patients with comorbidities. Another problem is donor availability, as a suitably human leukocyte antigen (HLA)-matched donor can be identified in a timely manner in only a subset of patients with relapsed or refractory disease.

Related HLA haplotype-mismatched (‘haploidentical’) bone marrow transplantation (BMT) is an alternative method to expand the potential pool of stem cell donors. The disadvantage of this strategy has been a high incidence of graft rejection and graft-versus-host disease (GvHD). Typically, investigators prefer to use T-cell-depleted or CD34+-selected grafts after intensive conditioning therapy. T-cell depletion of the graft significantly reduces the incidence and severity of GvHD, but at the expense of increased graft rejection, infection and relapse. Consequently, T-cell depletion of the graft has not been shown to improve outcomes after HLA-mismatched aSCT.1

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

References

  1. Schetelig J, Kiani A, Schmitz M, Ehninger G, Bornhäuser M . T cell-mediated graft-versus-leukemia reactions after allogeneic stem cell transplantation. Cancer Immunol Immunother 2005; 54: 1043–1058.

    Article  Google Scholar 

  2. Luznik L, Fuchs EJ . High-dose, post-transplantation cyclophosphamide to promote graft-host tolerance after allogeneic hematopoietic stem cell transplantation. Immunol Res 2010; 47: 65–77.

    Article  CAS  Google Scholar 

  3. Luznik L, O’Donnell PV, Symons HJ, Chen AR, Leffell MS, Zahurak M et al. HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, post-transplantation cyclophosphamide. Biol Blood Marrow Transplant 2008; 14: 641–650.

    Article  CAS  Google Scholar 

  4. Kasamon YL, Luznik L, Leffell MS, Kowalski J, Tsai HL, Bolaños-Meade J et al. Nonmyeloablative HLA-haploidentical bone marrow transplantation with high-dose post-transplantation cyclophosphamide: effect of HLA disparity on outcome. Biol Blood Marrow Transplant 2010; 16: 482–489.

    Article  CAS  Google Scholar 

  5. Mayumi H, Himeno K, Tokuda N, Nomoto K . Drug-induced tolerance to allografts in mice. VII. Optimal protocol and mechanism of cyclophosphamide-induced tolerance in an H-2 haplotype-identical strain combination. Transplant Proc 1986; 18: 363–369.

    CAS  PubMed  Google Scholar 

  6. Nomoto K, Eto M, Yanaga K, Nishimura Y, Maeda T . Interference with cyclophosphamide-induced skin allograft tolerance by cyclosporin A. J Immunol 1992; 149: 2668–2674.

    CAS  PubMed  Google Scholar 

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

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. S Tuve, J Gayoso and C Scheid: These authors contributed equally to this work

Authors and Affiliations

  1. Medizinische Klinik und Poliklinik I, Universitätsklinikum Dresden, Dresden, Germany

    S Tuve, J Radke, U Platzbecker, M Wermke, J M Middeke, N Shayegi, N Gruner, J Schetelig, C Thiede, G Ehninger & M Bornhäuser

  2. Servicio de Hematología-UTMO, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    J Gayoso, D Serrano, G Rodríguez-Macías, P Balsalobre & J L Díez-Martín

  3. Klinik I für Innere Medizin, Universitätsklinikum Köln, Köln, Germany

    C Scheid, U Holtick, J M Chemnitz, A Krause & M Hallek

  4. Medizinische Klinik IV, Klinikum Bayreuth, Bayreuth, Germany

    A Kiani

  5. DKMS Life Science Lab GmbH, Dresden, Germany

    M Füssel

  6. Center for Regenerative Therapies, Technical University Dresden, Dresden, Germany

    G Ehninger & M Bornhäuser

Authors
  1. S Tuve
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Gayoso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C Scheid
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J Radke
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Kiani
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D Serrano
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. U Platzbecker
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G Rodríguez-Macías
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. M Wermke
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. U Holtick
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. P Balsalobre
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. J M Middeke
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. N Shayegi
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. J M Chemnitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. A Krause
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. N Gruner
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. M Füssel
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. J Schetelig
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. C Thiede
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. G Ehninger
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. M Hallek
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. J L Díez-Martín
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. M Bornhäuser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Bornhäuser.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Author contributions

MF performed the determination of KIR-L mismatching. ST, JG, CS, JR, AK, DS, UP, GRM, MW, UH, PB, JMM, NS, JMC, AK, NG, JS, GE, MH, JLDM and MB were responsible for clinical care and out-patient follow-up. CT performed chimerism analyses. ST, JG, CS and MB wrote the paper and we have read and approved the final version of the manuscript.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tuve, S., Gayoso, J., Scheid, C. et al. Haploidentical bone marrow transplantation with post-grafting cyclophosphamide: multicenter experience with an alternative salvage strategy. Leukemia 25, 880–883 (2011). https://doi.org/10.1038/leu.2011.11

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/leu.2011.11

This article is cited by

Search

Advanced search

Quick links