Long-term outcomes of HLA-haploidentical stem cell transplantation based on an FBCA conditioning regimen compared with those of HLA-identical sibling stem cell transplantation for haematologic malignancies

Abstract

A comparison was conducted of 213 patients with haematologic malignancies who underwent HLA-identical sibling (n = 108) or HLA-haploidentical (n = 105) haematopoietic cell transplantation (haplo-HCT) at our centre. The conditioning regimen included fludarabine, busulphan, cyclophosphamide and antilymphocyte globulin (ATG) (FBCA). The total dose of ATG differed between identical and haploidentical groups (3.75 mg/kg versus 12.5 mg/kg). The cumulative incidences of grade II-IV acute GvHD in the identical and haploidentical groups were 20.4% and 21.9% (P = 0.73), and 2-year cumulative incidences of chronic GvHD were 36.4% and 24.1% (P = 0.17), respectively. The 3-year probabilities of non-relapse mortality for identical and haploidentical groups were 20.5% and 34.9% (P = 0.048), and for relapse were 22.2% and 21.0% (P = 0.85), respectively. The 3-year overall survivals in the identical and haploidentical groups were 62.6% and 52.6% (P = 0.054), whereas the 3-year disease-free survivals were 54.7% and 43.1% (P = 0.14), respectively. In the multivariate analysis, patients in the high-risk group exhibited reduced survival, and the higher dose of mononuclear or CD34+ cells resulted in an increase in the likelihood of survival. In conclusion, haplo-HCT based on an FBCA conditioning regimen could achieve nearly comparable outcomes to HLA-identical sibling HCT.

Potent immunomodulation and angiogenic effects of mesenchymal stem cells versus cardiomyocytes derived from pluripotent stem cells for treatment of heart failure

“…Increasing evidence has demonstrated that HLA plays a critical role in the regulation of the allogeneic response of stem cell transplantation [37, 38]. Indeed, transplantation of the MHC-matched allogeneic iPSC-CMs from homozygous monkey survived for up to 12 weeks in the infarcted myocardium without evidence of immune rejection in non-human primate treated with methylprednisolone and tacrolimus only.…”

The consensus on indications, conditioning regimen, and donor selection of allogeneic hematopoietic cell transplantation for hematological diseases in China—recommendations from the Chinese Society of Hematology

“…The modified G-CSF + ATG protocols with pure G-BM or G-PB were also feasible compared to the mixed grafts of G-PB and G-BM in HID-HSCT introduced by the Beijing group [ 21 , 77 ]. A propensity score method-based multicenter study demonstrated that HID-HSCT with mixed grafts achieved better 3-year DFS compared to G-PB alone (59.9 vs. 44.3%) [ 78 ].…”

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“…The 3-year probabilities of nonrelapse mortality for identical and haploidentical groups were 20.5% and 34.9% (P=0.048), and for relapse were 22.2% and 21.0% (P=0.85), respectively. The 3-year overall survivals in the identical and haploidentical groups were 62.6% and 52.6% (P=0.054), whereas the 3-year disease-free survivals were 54.7% and 43.1% (P=0.14), respectively [3]. In a series of 54 patients undergoing haploidentical donor transplantation (HAPLO) compared to those from a control group of patients receiving cells from matched or mismatched unrelated donors (URD) selected by diagnosis and stem cell source transplantation outcomes were compared.…”

“…Long H et al [3] while studying the long-term outcomes of HLA-haploidentical stem cell transplantation based on an FBCA (fludarabine, busulphan, cyclophosphamide, anti-thymocyte globulin) conditioning regimen compared with those of HLAidentical sibling stem cell transplantation for haematologic malignancies concluded that haplo-SCT could achieve nearly comparable outcomes to HLA-identical sibling SCT. In this study a comparison was conducted of 213 patients with haematologic malignancies who underwent HLA-identical sibling (n=108) or HLA-haploidentical (n=105) haematopoietic cell transplantation (haplo-HCT).…”