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Haploidentical hematopoietic stem cell transplantation for hematologic malignancies: a novel conditioning regimen with anti-T lymphocyte immunoglobulin instead of anti-thymocyte globulin for in vivo T cell depletion

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机构: [1]Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Affiliated Hosp, Dept Hematol, Chengdu, Peoples R China [2]Sichuan Prov Clin Res Ctr Hematol Dis, Chengdu, Peoples R China [3]Sichuan Acad Med Sci, Inst Hematol, Chengdu, Peoples R China
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We evaluated the safety and efficacy of a novel protocol for haploidentical stem cell transplantation (haplo-SCT) in 312 patients with hematologic malignancies. The protocol evolved from the Beijing platform replacing ATG with ATLG; adding Fludarabine and removing cytarabine and Simustine. GVHD prophylaxis combined Basiliximab and low-dose cyclophosphamide post-transplant; overall, the conditioning duration was shortened. Median times to neutrophil and platelet recovery were both 11 days. Graft rejection occurred in 0.96% of patients. Cumulative incidences of grades II-IV and III-IV acute GVHD by day 200 were 35.3% and 8.9%, respectively. Probabilities of total and extensive chronic GVHD at 2 years were 40.7% and 14.7%. CMV viremia was observed in 35.6% of patients, with a 1.9% 100-day CMV pneumonia incidence and no CMV-related mortality. Cumulative incidences of non-relapse mortality at 100 days, 1 year, and 2 years were 2.9, 4.4, and 6.6%. The 4-year OS, RFS, and GRFS rates were 78.9, 70.7, and 47.3%. Older recipient age was associated with higher NRM, while positive pre-transplant MRD predicted worse OS, RFS, and higher relapse incidence. Our novel protocol for haplo-SCT is associated with low infection rates and acceptable risks of graft failure, severe GVHD, and mortality, representing a safe and effective haploidentical transplantation strategy.

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大类 | 2 区 医学
小类 | 2 区 移植 3 区 血液学 3 区 免疫学 3 区 肿瘤学
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Q1 HEMATOLOGY Q1 ONCOLOGY Q1 TRANSPLANTATION Q2 IMMUNOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2024版] 出版当年五年平均 出版前一年[2024版]

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第一作者机构: [1]Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Affiliated Hosp, Dept Hematol, Chengdu, Peoples R China [2]Sichuan Prov Clin Res Ctr Hematol Dis, Chengdu, Peoples R China [3]Sichuan Acad Med Sci, Inst Hematol, Chengdu, Peoples R China
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通讯机构: [1]Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Affiliated Hosp, Dept Hematol, Chengdu, Peoples R China [2]Sichuan Prov Clin Res Ctr Hematol Dis, Chengdu, Peoples R China [3]Sichuan Acad Med Sci, Inst Hematol, Chengdu, Peoples R China
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