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Ai H, Chao NJ, Rizzieri DA, Huang X, Spitzer TR, Wang J, Guo M, Keating A, Krakow EF, Blaise D, Ma J, Wu D, Reagan J, Gergis U, Duarte RF, Chaudhary PM, Hu K, Yu C, Sun Q, Fuchs E, Cai B, Huang Y, Qiao J, Gottlieb D, Schultz KR, Liu M, Chen X, Chen W, Wang J, Zhang X, Li J, Huang H, Sun Z, Li F, Yang L, Zhang L, Li L, Liu K, Jin J, Liu Q, Liu D, Gao C, Fan C, Wei L, Zhang X, Hu L, Zhang W, Tian Y, Han W, Zhu J, Xiao Z, Zhou D, Zhang B, Jia Y, Zhang Y, Wu X, Shen X, Lu X, Zhan X, Sun X, Xiao Y, Wang J, Shi X, Zheng B, Chen J, Ding B, Wang Z, Zhou F, Zhang M, Zhang Y, Sun J, Xia B, Chen B, Ma L. Expert consensus on microtransplant for acute myeloid leukemia in elderly patients -report from the international microtransplant interest group. Heliyon 2023; 9:e14924. [PMID: 37089296 PMCID: PMC10119710 DOI: 10.1016/j.heliyon.2023.e14924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/05/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
Recent studies have shown that microtransplant (MST) could improve outcome of patients with elderly acute myeloid leukemia (EAML). To further standardize the MST therapy and improve outcomes in EAML patients, based on analysis of the literature on MST, especially MST with EAML from January 1st, 2011 to November 30th, 2022, the International Microtransplant Interest Group provides recommendations and considerations for MST in the treatment of EAML. Four major issues related to MST for treating EAML were addressed: therapeutic principle of MST (1), candidates for MST (2), induction chemotherapy regimens (3), and post-remission therapy based on MST (4). Others included donor screening, infusion of donor cells, laboratory examinations, and complications of treatment.
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Li W, Xu Y, Feng Y, Zhou H, Ma X, Wu D, Chen S, Sun A. The clinical application of SNP-based next-generation sequencing (SNP-NGS) for evaluation of chimerism and microchimerism after HLA-mismatched stem cell microtransplantation. Int J Hematol 2022; 116:723-730. [PMID: 35802296 PMCID: PMC9588463 DOI: 10.1007/s12185-022-03415-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022]
Abstract
Genetic diagnostic methods for evaluation of chimerism after HSCT, such as STR-PCR and XY-FISH, have limited sensitivity. When donor chimerism is in the micro range (< 1%), deviations in the accuracy of assessment are the most significant disadvantage of these common methods. We developed a highly sensitive method that applies SNPs based on NGS in order to explore the value of donor cell microchimerism in microtransplantation (MST). This improved SNP-NGS approach has higher sensitivity (0.01–0.05%) and only requires a small amount of DNA (8–200 ng). We retrospectively analyzed the clinical data of 48 patients with AML who received HLA-mismatched stem cell MST at our center to assess the impact of microchimerism on clinical prognosis. Patients whose duration of microchimerism was > 10.5 months (median) had a relapse rate of 26.1%, and had better 5-year LFS and OS (73.4% and 82.6%). In contrast, patients whose duration of microchimerism was < 10.5 months had a higher relapse rate (69.6%), and their 5-year LFS and OS were 30.4% and 43.5%. In conclusion, duration of donor chimerism is highly valuable for assessment of survival and prognosis in patients with AML who have received HLA-mismatched stem cell MST, especially the intermediate-risk group.
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Affiliation(s)
- Weiyang Li
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Yi Xu
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
| | - Yufeng Feng
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China
| | - Haixia Zhou
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China
| | - Xiao Ma
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Depei Wu
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China
- Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, People's Republic of China
| | - Suning Chen
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China.
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China.
| | - Aining Sun
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China.
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China.
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3
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Huang Y, Hong M, Qu Z, Zheng W, Hu H, Li L, Lu T, Xie Y, Ying S, Zhu Y, Liu L, Huang W, Fu S, Chen J, Wu K, Liu M, Luo Q, Wu Y, He F, Zhang J, Zhang J, Chen Y, Zhao M, Cai Z, Huang H, Sun J. Non-Ablative Chemotherapy Followed by HLA-Mismatched Allogeneic CD3 + T-Cells Infusion Causes An Augment of T-Cells With Mild CRS: A Multi-Centers Single-Arm Prospective Study on Elderly Acute Myeloid Leukemia and int-2/High Risk Myelodysplastic Syndrome Patients. Front Oncol 2021; 11:741341. [PMID: 34722293 PMCID: PMC8548743 DOI: 10.3389/fonc.2021.741341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate the efficacy and safety of standard or low-dose chemotherapy followed by HLA-mismatched allogeneic T-cell infusion (allo-TLI) for the treatment of elderly patients with acute myeloid leukemia (AML) and patients with intermediate-2 to high-risk myelodysplastic syndrome (MDS). Methods We carried out a prospective, multicenter, single-arm clinical trial. Totally of 25 patients were enrolled, including 17 AML patients and 8 MDS patients. Each patient received four courses of non-ablative chemotherapy, with HLA-mismatched donor CD3+ allo-TLI 24 h after each course. AML patients received chemotherapy with decitabine, idarubicin, and cytarabine, and MDS patients received decitabine, cytarabine, aclarubicin, and granulocyte colony-stimulating factor. Results A total of 79 procedures were performed. The overall response rates of the AML and MDS patients were 94% and 75% and the 1-year overall survival rates were 88% (61-97%) and 60% (13-88%), respectively. The overall 60-day treatment-related mortality was 8%. Compared with a historical control cohort that received idarubicin plus cytarabine (3 + 7), the study group showed significantly better overall response (94% vs. 50%, P=0.002) and overall survival rates (the 1-year OS rate was 88% vs. 27%, P=0.014). Post-TLI cytokine-release syndrome (CRS) occurred after 79% of allo-TLI operations, and 96% of CRS reactions were grade 1. Conclusion Elderly AML patients and intermediate-2 to high-risk MDS patients are usually insensitive to or cannot tolerate regular chemotherapies, and may not have the opportunity to undergo allogeneic stem cell transplantation. Our study showed that non-ablative chemotherapy followed by HLA-mismatched allo-TLI is safe and effective, and may thus be used as a first-line treatment for these patients. Clinical Trial Registration https://www.chictr.org.cn/showproj.aspx?proj=20112.
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Affiliation(s)
- Yan Huang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minghua Hong
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhigang Qu
- Department of Hematology, Yiwu Central Hospital, Yiwu, China
| | - Weiyan Zheng
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huixian Hu
- Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Linjie Li
- Department of Hematology, The Central Hospital of Lishui City, Lishui, China
| | - Ting Lu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Xie
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuangwei Ying
- Department of Hematology, Taizhou Hospital of Zhejiang Province, Taizhou, China
| | - Yuanyuan Zhu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lizhen Liu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weijia Huang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shan Fu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jin Chen
- Department of Hematology, Yiwu Central Hospital, Yiwu, China
| | - Kangli Wu
- Department of Hematology, Yiwu Central Hospital, Yiwu, China
| | - Mingsuo Liu
- Department of Hematology, Yiwu Central Hospital, Yiwu, China
| | - Qiulian Luo
- Department of Hematology, Yiwu Central Hospital, Yiwu, China
| | - Yajun Wu
- Department of Hematology, Yiwu Central Hospital, Yiwu, China
| | - Fang He
- Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Jingcheng Zhang
- Department of Hematology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Junyu Zhang
- Department of Hematology, The Central Hospital of Lishui City, Lishui, China
| | - Yu Chen
- Department of Hematology, The Central Hospital of Lishui City, Lishui, China
| | - Minlei Zhao
- Department of Hematology, The Central Hospital of Lishui City, Lishui, China
| | - Zhen Cai
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - He Huang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Sun
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy; Zhejiang Laboratory for Systems & Precison Medicine, Zhejiang University Medical Center, Institute of Hematology, Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Li M, Li C, Geng S, Chen X, Wu P, Deng C, Chen X, Lu Z, Weng J, Du X. Decitabine With or Without Micro-Transplantation for the Treatment of Intermediate or High-Risk Myelodysplastic Syndrome: A Chinese Single-Center Retrospective Study of 22 Patients. Front Oncol 2021; 11:628127. [PMID: 33869012 PMCID: PMC8044401 DOI: 10.3389/fonc.2021.628127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
The treatment outcomes of intermediate or high-risk myelodysplastic syndrome (MDS) remain unsatisfactory. This study was designed to evaluate the safety and efficacy of human leukocyte antigen (HLA)-mismatched hematopoietic stem cell micro-transplantation (MST) in patients with MDS. A total of 22 patients with MDS, ranging between the ages of 39 and 74, were enrolled in this study. Eleven patients were given decitabine (DAC), a DNA methyltransferase inhibitor, combined with HLA-mismatched MST (MST-DAC group), and the remaining patients were given decitabine only (DAC group). The median overall survival (OS) of the MST-DAC group was higher than that of the DAC group (24 vs. 14.3 months; HR 0.32; 95% CI: 0.11-0.96; p = 0.04), although it is a study with small samples. The overall response rate (ORR), marrow complete remission (mCR), plus hematological improvement (HI) rates of the MST-DAC group were higher than that of the DAC group (81.8 vs. 54.5%, p = 0.36; 63.6 vs. 27.3%, p = 0.09, respectively); however, there were no statistical differences between the two groups, which may be attributed to the limited number of cases evaluated in this study. No graft-vs.-host disease was observed in the MST-DAC group. Patients in the MST-DAC group demonstrated a slightly lower incidence of hematological and non-hematological adverse events (AEs). DAC combined with HLA-mismatched MST may provide a novel, effective, and safe treatment for use in intermediate or high-risk MDS pathologies.
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Affiliation(s)
- MinMing Li
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chao Li
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Hematology, School of Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, South China University of Technology, Guangzhou, China
| | - SuXia Geng
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - XiaoMei Chen
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ping Wu
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - ChengXin Deng
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - XiaoFang Chen
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - ZeSheng Lu
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - JianYu Weng
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Hematology, School of Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, South China University of Technology, Guangzhou, China
| | - Xin Du
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Hematology, School of Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, South China University of Technology, Guangzhou, China
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5
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Cornillon J, Carre M, Chalandon Y, Chevallier P, Coman T, Harif M, Labuissière-Wallet H, Mear JB, Picard C, Yakoub-Agha I, Srour M. [Indications and management of hematologic microtransplantation: Recommendations of the French Society of Bone Marrow transplantation and cellular Therapy (SFGM-TC)]. Bull Cancer 2020; 107:S130-S139. [PMID: 32560899 DOI: 10.1016/j.bulcan.2020.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 10/24/2022]
Abstract
Microtransplantation (MT) is based on injection of HLA-mismatched G-CSF mobilized hematopoietic stem cells, in combination with chemotherapy but without use of conditioning regimen nor immunosuppressive drugs. As a result, a transient microchimerism is induced without engraftment. Its efficacy relies both on host immune system stimulation (recipient versus tumor) and on a graft versus tumor effect. Data are scarce and concern mostly Asian patients with acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (HR-MDS). In comparison to conventional treatment without MT, higher complete remission rates and longer disease free survival and overall survival have been reported. Safety seems acceptable. The most frequent adverse event is non-severe cytokine release syndrome. Risk of GVHD remains very low. Here, we summarize the published data and detail the practical aspects of the procedure. Current data are not strong enough to provide recommendations on indications. Nevertheless, it seems reasonable to propose MT to patients with AML or HR-MDS, regardless of age, presenting an indication for allogeneic stem cell transplantation but ineligible for it. MT is still under investigation and rather be proposed within clinical trials.
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Affiliation(s)
- Jérôme Cornillon
- Institut de cancérologie Lucien-Neuwirth, département d'hématologie et de thérapie cellulaire, 108, bis, avenue Albert-Raimond, 42271 Saint-Priest en Jarez, France.
| | - Martin Carre
- CHU de Grenoble, clinique universitaire d'hématologie, boulevard de la Chantourne, 38700 La Tronche, France
| | - Yves Chalandon
- Hôpitaux universitaires Genève, université de Genève, faculté de médecine, service d'hématologie, département d'oncologie, Genève, Suisse
| | - Patrice Chevallier
- CHU de hôtel-dieu, service d'hématologie clinique, place A. Ricordeau, 44093 Nantes cedex, France
| | - Teresa Coman
- Institut Gustave-Roussy, département d'hématologie, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - Mhamed Harif
- Faculté de médecine et de pharmacie, 19, rue Tariq Ben Zayad, Casablanca, Maroc
| | | | - Jean-Baptiste Mear
- CHU de Renens, service d'hématologie clinique, 2, avenue Louis-Guilloux, 35000 Rennes, France
| | - Christophe Picard
- Établissement français du sang, EFS PACA-Corse, laboratoire HLA/HPA, Marseille, France
| | - Ibrahim Yakoub-Agha
- Hôpital Huriez, CHRU de Lille, maladie du sang, 3, rue Michel-Polonowsky, 59000 Lille, France
| | - Micha Srour
- Hôpital Huriez, CHRU de Lille, maladie du sang, 3, rue Michel-Polonowsky, 59000 Lille, France
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6
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Hu K, Du X, Guo M, Yu C, Qiao J, Sun Q, Zuo H, Cai B, Huang Y, Ai H, Dong Z, Wang Y. Comparative study of micro-transplantation from HLA fully mismatched unrelated and partly matched related donors in acute myeloid leukemia. Am J Hematol 2020; 95:630-636. [PMID: 32157700 DOI: 10.1002/ajh.25780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/12/2020] [Accepted: 02/27/2020] [Indexed: 11/09/2022]
Abstract
Micro-transplantation (MST) by chemotherapy, combined with granulocyte colony-stimulating factor-mobilized peripheral blood stem cell (GPBSC) infusion, from an HLA partial matched related donor has shown some encouraging effective therapy for acute myeloid leukemia (AML). However, the outcome of human leukocyte antigen (HLA) fully mismatched unrelated donor-derived MST in such patients is still unknown. In the present study, we compared the efficacy of HLA fully mismatched unrelated donor-derived MST, and partly matched related donor-derived MST, in AML of 126 patients from two centers in China, These patients, aged 16 to 65 years, were given three or four courses of MST, which consisted of a high dosage cytarabine followed by GPBSC from unrelated donor or related donor. There was a statistically significant difference in 3-year leukemia-free survival (LFS) and 3-year overall survival (OS) between the unrelated and the related group. The non-treatment-related mortality (NRM) rates of patients, and other adverse complications, were no different in the two groups. In conclusion, unrelated donor-derived MST is believed to be a safe treatment, with efficacy similar to or higher than related donor-derived MST. This result provides support for the potential of MST for expanding the donor selection. However, the specific mechanism of action needs further study.
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Affiliation(s)
- Kai‐Xun Hu
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Xin Du
- Department of HematologyGuangdong Peopleʼs Hospital Gongdong China
| | - Mei Guo
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Chang‐Lin Yu
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Jian‐Hui Qiao
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Qi‐Yun Sun
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Hong‐Li Zuo
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Bo Cai
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Ya‐Jing Huang
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Hui‐Sheng Ai
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Zheng Dong
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
| | - Yi Wang
- Department of Hematology and Transplantation, Fifth Medical CenterGeneral Hospital of the Chinese Peopleʼs Liberation Army Beijing China
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7
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Hu KX, Ai HS, Guo M, Yu CL, Qiao JH, Sun QY, Dong Z, Cai B, Sun WJ, Wang Y, Zhan X, Liu X. Donor Selection in HLA-Mismatched Hematopoietic Stem Cell Microtransplantation for Acute Myeloid Leukemia. Stem Cells Dev 2020; 29:648-654. [PMID: 32122266 DOI: 10.1089/scd.2019.0295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kai-Xun Hu
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Hui-Sheng Ai
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Mei Guo
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Chang-Lin Yu
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Jian-Hui Qiao
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Qi-Yun Sun
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Zheng Dong
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Bo Cai
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Wan-Jun Sun
- Department of Hematology, Second Artillery General Hospital, Beijing, China
| | - Yi Wang
- Department of Hematology and Transplantation, the Fifth Medical Center of the People's Liberation Army General Hospital, Beijing, China
| | - Xinrong Zhan
- Department of Hematology, Central Hospital of Xinxiang City, Xinxiang, China
| | - Xiangjun Liu
- Cellular and Molecular Diagnostic Lab of Jing-Meng Hi-Tech Stem Cell, Beijing, China
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8
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Andrikovics H, Őrfi Z, Meggyesi N, Bors A, Varga L, Kövy P, Vilimszky Z, Kolics F, Gopcsa L, Reményi P, Tordai A. Current Trends in Applications of Circulatory Microchimerism Detection in Transplantation. Int J Mol Sci 2019; 20:E4450. [PMID: 31509957 PMCID: PMC6769866 DOI: 10.3390/ijms20184450] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 02/07/2023] Open
Abstract
Primarily due to recent advances of detection techniques, microchimerism (the proportion of minor variant population is below 1%) has recently gained increasing attention in the field of transplantation. Availability of polymorphic markers, such as deletion insertion or single nucleotide polymorphisms along with a vast array of high sensitivity detection techniques, allow the accurate detection of small quantities of donor- or recipient-related materials. This diagnostic information can improve monitoring of allograft injuries in solid organ transplantations (SOT) as well as facilitate early detection of relapse in allogeneic hematopoietic stem cell transplantation (allo-HSCT). In the present review, genetic marker and detection platform options applicable for microchimerism detection are discussed. Furthermore, current results of relevant clinical studies in the context of microchimerism and SOT or allo-HSCT respectively are also summarized.
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Affiliation(s)
- Hajnalka Andrikovics
- Laboratory of Molecular Genetics, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
- Department of Pathophysiology, Semmelweis University, 1089 Budapest, Hungary
| | - Zoltán Őrfi
- Laboratory of Molecular Genetics, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
| | - Nóra Meggyesi
- Laboratory of Molecular Genetics, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
| | - András Bors
- Laboratory of Molecular Genetics, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
| | - Lívia Varga
- School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
- Hungarian National Blood Transfusion Service, 1113 Budapest, Hungary
| | - Petra Kövy
- Laboratory of Molecular Genetics, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
- School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
| | - Zsófia Vilimszky
- Laboratory of Molecular Genetics, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
| | - Fanni Kolics
- Laboratory of Molecular Genetics, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
| | - László Gopcsa
- Department of Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
| | - Péter Reményi
- Department of Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, Hungary
| | - Attila Tordai
- Department of Pathophysiology, Semmelweis University, 1089 Budapest, Hungary.
- Department of Transfusion Medicine, Semmelweis University, 1089 Budapest, Hungary.
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