Haploidentical transplantation outcomes are comparable with those obtained with identical human leukocyte antigen allogeneic transplantation in Chilean patients with benign and malignant hemopathies

Sarmiento, Mauricio; Ramírez, Pablo; Jara, Verónica; Bertín, Pablo; Galleguillos, Mauricio; Rodríguez, Isabel; Lorca, Carla; Pizarro, Isabel; Rivera, Elizabeth; Ocqueteau, Mauricio

doi:10.1016/j.htct.2019.01.010

Cited by 7 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our program performs hospitalized transplantations. Immunosuppressor monitoring and the administration of granulocyte-colony stimulating factor (G-CSF), antibiotics, antifungals, antiviral prophylactics, and related treatments are standardized according to institutional guidelines and were reported previously 6 .…”

Section: Transplantation Proceduresmentioning

confidence: 99%

Desensitization therapy for elevated donor-specific antibody levels in haploidentical transplantation in Chilean patients

Sarmiento,

Salinas,

Rojas

et al. 2024

jbmtct

View full text Add to dashboard Cite

Allogeneic stem cell transplantation (ALOSCT) is curative for several hematological diseases. Unrelated donors and cord blood stem cells are valid options but haploidentical donors (HAPLO) have been considered the main source of stem cells in several countries, partly due to easy access and low cost of the transplantation process. Unfortunately, some patients have antibodies against the HLA epitopes from family haploidentical donors (donor-specific antibodies [DSA]) which are associated with engraftment failure and lethality. A few strategies exist to reduce or eliminate HLA antibodies that bind to these receptors. In this study, we present our experience with DSA desensitization by retrospectively examining a cohort from our hospital program. Between 2012 and 2023, we performed 243 ALOSCTs, of which 142 were from HAPLO and 56 were from unrelated donors. Nine patients (7%) had elevated DSA levels, most of which were female patients and mostly HAPLO. The median fluorescence intensity for these patients was 22,490 (19,000-28,560). Most of these high DSA patients (80%) received a desensitization procedure that involves plasmapheresis, rituximab, and immunoglobulin. The remaining 20% had severe infections during transplantation, and received rituximab monotherapy instead. The median dose of stem cells infused was 6.5 x 10^6 CD34/kg. Graft-versus-host disease (GVHD) preventative measures for all patients involved post-transplantation cyclophosphamide. Primary graft failure was observed in 45% of DSA elevated patients. For the remaining patients, median granulocyte and platelet engraftment were 14 d (12-16) and 16 d (13-18), respectively. Mortality in patients who did not receive engraftment was 100%. The incidence of mild, chronic GVHD was 15%. In conclusion, the desensitization of DSA in patients provided a 55% rate of engraftment and survival. However, a 45% rate of primary graft failure continued to pose a challenge in patients with DSA and required the development of improved strategies to reduce elevated transplant-related mortality.

show abstract

Section: Transplantation Proceduresmentioning

confidence: 99%

Desensitization therapy for elevated donor-specific antibody levels in haploidentical transplantation in Chilean patients

Sarmiento,

Salinas,

Rojas

et al. 2024

jbmtct

View full text Add to dashboard Cite

show abstract

“…El procedimiento en extenso de valoración pretrasplante fue reportado previamente 6,7 . Al diagnóstico o en las fases iniciales del tratamiento del paciente evaluamos la compatibilidad de los potenciales donantes emparentados por medio de genotipificación de HLA A, B, C, DRB buscando un hermano 100% compatible.…”

Section: Trasplante Hematopoyético: Donante Y Pacienteunclassified

“…El uso de tratamientos preparatorios de intensidad reducida, con significativamente menor toxicidad que los tratamientos mieloablativos han permitido trasplantar pacientes cada vez de mayor edad con resultados comparables a los pacientes más jóvenes 6 . Por otra parte, los donantes familiares haploidénticos (50%) han permitido extender el trasplante a pacientes sin hermanos 100% compatibles 7 . En último término la disponibilidad de donantes no emparentados de registros nacionales e internacionales ha permitido encontrar donantes en aquellos sin familiares disponibles.…”

unclassified

Resultados a largo plazo de una cohorte chilena: la edad del paciente no incide en el resultado del trasplante alogénico de precursores hematopoyéticos para leucemia mieloide aguda

et al. 2021

Self Cite

View full text Add to dashboard Cite

Age does not affect the outcome of allogeneic hematopoietic precursor transplantation for acute myeloid leukemia Background: In our country, transplantation centers differ in the age limit for allogeneic hematopoietic transplantation (ALOHT). In our program, transplants with age-adjusted conditioning are performed in patients until 70 years old. Currently more than 60% of ALOHT reported to the Center for International Bone Marrow Transplantation Research (CIBMTR) are performed in patients older than 40 years. Aim: To report our experience with ALOHT in acute myelogenous leukemia (AML), analyzing patient age at transplantation in different periods and transplant results in different age groups. Material and Methods: A retrospective analysis of the database of adult hematopoietic transplants in AML patients was performed. Demographic data, disease characteristics, transplant data, survival and relapse times, and mortality were collected. Results: In our program, 1030 transplants were performed in adults and 119 ALOHT were performed in AML patients, between 1990 and 2020. The median age of patients in all periods was 41 years, (range 16-69). The median age was 33 and 45 years, in the periods 1990-2000 and 2000-2020 respectively (p < 0.01). Seventy-eight patients received myeloablative conditioning (median age 44 years) and 41 reduced intensity conditioning (median age 53 years). Five-year overall survival was 44.6% (confidence intervals . Non relapse mortality of all periods was 19% (CI 17 -40%) and relapse rate was 17 % . No difference in five years overall survival among patients younger than 40, 41 to 50 and over 51 years was observed. Conclusions: Overall Survival, non-relapse mortality and relapse rate were similar in younger and older patients in our program and similar to those previously reported in other centers.

show abstract

“…HSTC can be classified according to its type; as autologous when the HPC are from the patient themself, as allogeneic when the cells are from donors (related or not) with compatible human leukocyte antigen (HLA), and syngeneic when the HPC are from an identical twin. The cells used for this type of transplant can be collected from bone marrow, peripheral blood or umbilical cord and placental blood 2 - 3 .…”

Section: Introductionmentioning

confidence: 99%

Análise dos fatores associados ao retransplante de células-tronco hematopoiéticas: estudo caso-controle

Azevedo

Júnior

Nascimento

et al. 2022

Rev. Latino-Am. Enfermagem

View full text Add to dashboard Cite

Resumo Objetivo: analisar os fatores associados ao insucesso do Transplante de Células-Tronco Hematopoiéticas (TCTH) em pacientes submetidos ao retransplante de Células-Tronco Hematopoiéticas (RCTH). Método: estudo quantitativo do tipo caso-controle para avaliar pacientes submetidos ao RCTH. Para tanto, utilizou-se amostra pareada de dois controles para cada caso (2:1). O grupo caso foi constituído pelos prontuários de saúde com todos os pacientes que foram submetidos ao RCTH (28) e o grupo controle (56) incluiu pacientes que receberam apenas um transplante. Três variáveis nortearam o pareamento: sexo, diagnóstico e tipo de transplante. Resultados: vinte e quatro (85,71%) pacientes do grupo caso receberam retransplante devido a recidiva da doença e quatro (14.29%) devido a falha do enxerto. Uma diferença estatística foi encontrada na análise entre os pacientes que não usaram o ácido ursodesoxicólico, analgésicos opioides ou imunossupressores. A necessidade de um RCTH entre aqueles que usaram estes medicamentos de forma inapropriada foi 16,12, 12,79 e 4,5 vezes maior, respectivamente, do que entre os que as usaram corretamente. Conclusão: houve uma diferença relacionada ao motivo que levou ao retransplante e os indivíduos analisados. A conclusão é que a razão preditiva para retransplante nesta amostra foi a recidiva da doença.

show abstract

Haploidentical transplantation outcomes are comparable with those obtained with identical human leukocyte antigen allogeneic transplantation in Chilean patients with benign and malignant hemopathies

Cited by 7 publications

References 15 publications

Desensitization therapy for elevated donor-specific antibody levels in haploidentical transplantation in Chilean patients

Desensitization therapy for elevated donor-specific antibody levels in haploidentical transplantation in Chilean patients

Resultados a largo plazo de una cohorte chilena: la edad del paciente no incide en el resultado del trasplante alogénico de precursores hematopoyéticos para leucemia mieloide aguda

Análise dos fatores associados ao retransplante de células-tronco hematopoiéticas: estudo caso-controle

Contact Info

Product

Resources

About