Unmanipulated haploidentical/mismatched related transplantation with combined granulocyte-colony stimulating factor-mobilised peripheral blood stem cells (G-PBSCs) and granulocyte-colony stimulating factor-mobilised bone marrow (G-BM) has been developed as an alternative transplantation strategy for patients with haematologic malignancies. However, little information is available about the factors predicting the outcome of peripheral blood stem cell (PBSC) collection and bone marrow (BM) harvest in this transplantation. The effects of donor characteristics and procedure factors on CD34+ cell yield were investigated. A total of 104 related healthy donors received granulocyte-colony stimulating factor (G-CSF) followed by PBSC collection and BM harvest. Male donors had significantly higher yields compared with female donors. In multiple regression analysis for peripheral blood collection, age and flow rate were negatively correlated with cell yield, whereas body mass index, pre-aphaeresis white blood cell (WBC) and circulating immature cell (CIC) counts were positively correlated with cell yields. For BM harvest, age was negatively correlated with cell yields, whereas pre-BM collection CIC counts were positively correlated with cell yield. All donors achieved the final product of ≥6 ×106 kg−1 recipient body weight. This transplantation strategy has been shown to be a feasible approach with acceptable outcomes in stem cell collection for patients who received HLA-haploidentical/mismatched transplantation with combined G-PBSCs and G-BM. In donors with multiple high-risk characteristics for poor aphaeresis CD34+ cell yield, BM was an alternative source.
We present the first report of a patient with refractory AML (with 58% blast cells) treated successfully with decitabine as a conditioning regimen in haploidentical HSCT.
Background: Background: Donor derived CD19 car T cells plus donor lymphocyte infusion is rarely used in the treatment of recurrent CD19 positive B-ALL after allogeneic hematopoietic stem cell transplantation (allo-HSCT) Aims: Aims: To compare the efficacy of donor derived CD19 car T cells and chemotherapy plus donor lymphocyte infusion in the treatment of recurrent CD19 positive B-ALL after allogeneic hematopoietic stem cell transplantation (allo-HSCT) Methods: Methods: We retrospectively analyzed 43 patients with B-ALL who relapsed after allo-HSCT from March 2016 to November 2019�including 22 patients treated with donor derived CD19-CAR-T cells (CAR-T group) and 21 patients treated with chemotherapy plus donor lymphocyte infusion (Chemo-DLI group).
Results: Results:The rates of complete remission (77.3%) in the CAR-T group were significantly higher than those in the Chemo-DLI group (38.1%) ; The 1-and 2-year leukemia-free survival(LFS) in the CAR-T group and Chemo-DLI group were 54.5% vs 9.5%, 45.5% vs 4.8% , respectively. The 1-and 2-year overall survival(OS) in the CAR-T group and Chemo-DLI group were 68.2% vs 19% , 63.6%vs 9.5%, respectively. Six patients (28.6%) in the Chemo-DLI group developed grade II-IV acute graft-versus-host disease (aGVHD). Two patients (9.1%) with grade I-II aGVHD were found in the CAR-T group. The incidence of CRS in the CAR-T group was 86.4%, the grade I-II CRS was59.1%, the grade III CRS was 27.3%. There was no grade 4 CRS. Two subjects developed ≤grade-2 immune effector cell-associated neurotoxicity syndrome (ICANS).
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