The impact of T-cell depletion techniques on the outcome after haploidentical hematopoietic SCT.
Bone Marrow Transplant
; 49(1): 55-61, 2014 Jan.
Article
em En
| MEDLINE
| ID: mdl-24037023
ABSTRACT
Several T-cell depletion (TCD) techniques are used for haploidentical hematopoietic SCT (HSCT), but direct comparisons are rare. We therefore studied the effect of in vitro TCD with graft engineering (CD34 selection or CD3/CD19 depletion, 74%) or in vivo TCD using alemtuzumab (26%) on outcome, immune reconstitution and infections after haploidentical HSCT. We performed a retrospective multicenter analysis of 72 haploidentical HSCT in Switzerland. Sixty-seven patients (93%) had neutrophil engraftment. The 1-year OS, TRM and relapse incidence were 48 (36-60)%, 20 (11-33)% and 42 (31-57)%, respectively, without differences among the TCD groups. In vivo TCD caused more profound lymphocyte suppression early after HSCT, whereas immune recovery beyond the second month was comparable between the two groups. Despite anti-infective prophylaxis, most patients experienced post-transplant infectious complications (94%). Patients with in vivo TCD had a higher incidence of CMV reactivations (54% vs 28%, P=0.015), but this did not result in a higher TRM. In conclusion, TCD by graft engineering or alemtuzumab are equally effective for haploidentical HSCT.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Linfócitos T
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Depleção Linfocítica
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Transplante de Células-Tronco Hematopoéticas
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Neoplasias Hematológicas
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
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Newborn
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article