Comparison of second transplantation and donor lymphocyte infusion for donor mixed chimerism after allogeneic stem cell transplantation for nonmalignant diseases.
Pediatr Blood Cancer
; 63(12): 2221-2229, 2016 12.
Article
en En
| MEDLINE
| ID: mdl-27554591
ABSTRACT
BACKGROUND:
Donor mixed chimerism (MC) is an increasing problem after hematopoietic stem cell transplantation (HSCT) for nonmalignant diseases. PROCEDURE In this study, a self-administered questionnaire was used to retrospectively compare efficacy and safety in 49 patients undergoing second HSCT (n = 13) or donor lymphocyte infusion (DLI; n = 36) as treatment for MC.RESULTS:
The response rate to DLI of patients with secondary graft failure (GF) (25.0%) was significantly lower than that of patients without secondary GF (81.3%; P = 0.041). Among patients undergoing DLI, the rates of successful response were significantly higher in patients having at least 30% donor chimerism (94.1%) than in patients having less than 30% donor chimerism (61.1%; P = 0.041). Furthermore, the rates of successful response were significantly higher in patients receiving larger first or maximum doses of DLI. Sixteen (50.0%) of 32 patients without secondary GF attained complete chimerism after DLI. The cumulative incidence of grade II-IV acute graft-versus-host disease and cytopenia was 37.6 and 26.1%, respectively.CONCLUSIONS:
DLI yields promising response rates in most patients with higher donor chimerism levels, whereas second HSCT is more likely to benefit patients with lower donor chimerism levels.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Quimera por Trasplante
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Transfusión de Linfocitos
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Trasplante de Células Madre Hematopoyéticas
Tipo de estudio:
Observational_studies
Límite:
Adolescent
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Adult
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Child
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Child, preschool
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Humans
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Infant
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Newborn
Idioma:
En
Año:
2016
Tipo del documento:
Article