HLA-DR-matched parental donors for allogeneic hematopoietic stem cell transplantation in patients with high-risk acute leukemia
Journal
Journal of the Formosan Medical Association
Journal Volume
108
Journal Issue
5
Pages
423-427
Date Issued
2009
Abstract
The immunomodulating effect of human leukocyte antigen (HLA)-DR and the central role of CD4 T cells in alloimmunity provide clues suggesting that HLA-DR-matched, partially mismatched related donors could be feasible alternative donors of allogeneic hematopoietic stem cells for transplantations (alloHSCT). We describe our experience with allo-HSCT in eight patients with high-risk acute leukemia; donors included one of each of the parents. Among the eight patients, seven were identical HLA-DR matches with the donors. The stem cells were not manipulated in vitro. Graft-versus-host disease (GVHD) prophylaxis consisted of antithymocyte globulin, cyclosporine, and methotrexate. All patients had successful trilineage engraftment. Only one patient had grade 2-4 acute GVHD. Two patients died before day +100 due to complications. At the end of follow-up, four patients had survived for 18-48 months and three are alive and without relapse. Our results suggest that HLA-DR fully-matched parents are feasible alternative donors for allo-HSCT in patients with high-risk acute leukemia under an intensive conditioning regimen. ?2009 Elsevier & Formosan Medical Association.
SDGs
Other Subjects
busulfan; cyclophosphamide; cyclosporin A; fludarabine; fludarabine phosphate; HLA DR antigen; methotrexate; recombinant granulocyte colony stimulating factor; thymocyte antibody; acute graft versus host disease; acute leukemia; adolescent; adult; allogeneic hematopoietic stem cell transplantation; article; Aspergillus; cancer survival; cell manipulation; chemoprophylaxis; chronic graft versus host disease; clinical article; cytomegalovirus infection; donor lymphocyte infusion; engraftment; father; feasibility study; female; graft versus host reaction; hematopoietic stem cell; high risk patient; HLA matching; human; immunosuppressive treatment; leukemia relapse; leukemia remission; living donor; lung mycosis; male; mortality; mother; neutropenia; parent; pilot study; virus pneumonia; virus reactivation; whole body radiation
Publisher
Scientific Communications International Ltd
Type
journal article