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Darrigo LG, Loth G, Kuwahara C, Vieira A, Colturato V, Rodrigues AL, Arcuri L, Fernandes J, Macedo A, Tavares R, Gomes A, Ribeiro L, Seber A, Zecchin V, de Souza M, Calixto R, Pasquini R, Flowers M, Rocha V, Bonfim C. Hematopoietic cell transplantation for Diamond Blackfan anemia: A report from the Pediatric Group of the Brazilian Bone Marrow Transplantation Society. Eur J Haematol 2020; 105:426-433. [PMID: 32525237 DOI: 10.1111/ejh.13463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The aim of this study was to analyze the outcomes of children with Diamond-Blackfan anemia (DBA) treated in Brazil with hematopoietic cell transplantation (HCT). METHODS We performed a retrospective analysis of 44 pediatrics patients transplanted between 1990 and 2018. The median age of patients was 5 years, and 57% were male. Twenty-five received their first HCT from an HLA-matched sibling donor (MSD), 12 from a HLA matched unrelated bone marrow donor (MUD 10/10, n = 12) and 7 other HLA mismatched donors (MMD). RESULTS After a median follow-up of 4 years, estimate 5-year overall survival (OS) for the entire cohort was 70%, 80% for MSD group, 73% for MUD, and 29% for MMD. Thirty-eight out of the 44 evaluable patients engrafted successfully. Primary and secondary graft failure was observed in five and three patients, respectively. Rates of grade II-IV and III-IV acute graft-versus-host disease (aGVHD) were 25% and 18%, respectively. Nine patients developed chronic GVHD (cGVHD). CONCLUSION Overall survival rates observed after HLA matched donors transplant for DBA were comparable to those reported from higher-income countries and international registries.
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Affiliation(s)
- Luiz Guilherme Darrigo
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Gisele Loth
- Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Ana Vieira
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | | | - Antonio Macedo
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rita Tavares
- Instituto Nacional de Cancer, Rio de Janeiro, Brazil
| | | | | | | | - Victor Zecchin
- Instituto de Oncologia Pediátrica-Graacc-Unifesp, São Paulo, Brazil
| | | | | | | | - Mary Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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2
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Darrigo LG, Colturato V, de Souza MP, Loth G, Calixto R, Seber A, Zecchin VG, Esteves Daudt L, Tavares RB, Arcuri L, de Macedo AV, Vieira AK, Kuwahara C, Ribeiro L, Fernandes JF, Flowers ME, Pasquini R, Bonfim C. Allogeneic Bone Marrow Transplants for Pediatric Severe Aplastic Anemia: Real-world Data comparing Matched Related and Unrelated Donors in a Developing Country. Retrospective study on behalf of the Pediatric Hematopoietic Stem Cell Transplant Working Group of the Brazilian Bone Marrow Transplantation Society (SBTMO) and the Brazil-Seattle Consortium (Gedeco). Pediatr Transplant 2019; 23:e13552. [PMID: 31297928 DOI: 10.1111/petr.13552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/29/2019] [Accepted: 06/18/2019] [Indexed: 01/06/2023]
Abstract
In this study, we report on major MRD or URD BMT outcomes in pediatric patients with SAA in Brazil. This was a retrospective study, which included 106 patients ≤18 years old who received a first BMT for SAA. All patients received bone marrow as graft source from an MRD (n = 69) or a URD (n = 37). Conditioning regimen was non-myeloablative in 73.6% of cases, and GVHD prophylaxis comprised a calcineurin inhibitor plus methotrexate in 89.6% of patients. After a median follow-up of 4.5 years after BMT, 81 patients are alive, with a 4-year OS of 77% and no statistically significant difference between the MRD and URD groups (82% vs. 69%, respectively; P = .08). Grade III-IV aGVHD at 6 months and cGVHD at 2 years were observed in 8% and 14% of cases, respectively, and were not statistically different between the groups. Twenty-five (23%) patients died at a median of 2.9 months after BMT. Our study showed that 4-year OS after BMT was not statistically different between MRD and URD recipients. This study shows that the outcomes of pediatric patients transplanted for SAA with a URD in Brazil are approaching those of MRD transplants. In contrast, OS after MRD BMT was lower than we would expect based on previous reports. The wide range of preparatory regimens used by the study centers highlights the need for standardized protocols for these children. Our findings provide a benchmark for future studies focused on improving BMT outcomes in this setting in Brazil.
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Affiliation(s)
| | | | | | - Gisele Loth
- Universidade Federal do Paraná, Curitiba, Brazil
| | - Rodolfo Calixto
- Real Hospital Português de Beneficência, Recife - PE, Brazil
| | | | | | | | | | | | | | | | | | | | | | - Mary E Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
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3
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Onishi Y, Mori T, Kako S, Koh H, Uchida N, Kondo T, Kobayashi T, Yabe H, Miyamoto T, Kato K, Suzuki R, Nakao S, Yamazaki H. Outcome of Second Transplantation Using Umbilical Cord Blood for Graft Failure after Allogeneic Hematopoietic Stem Cell Transplantation for Aplastic Anemia. Biol Blood Marrow Transplant 2017; 23:2137-2142. [PMID: 28844947 DOI: 10.1016/j.bbmt.2017.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 08/14/2017] [Indexed: 12/15/2022]
Abstract
Graft failure (GF) is the most critical life-threatening complication of allogeneic hematopoietic stem cell transplantation (HSCT) for aplastic anemia, for which a second transplantation is the only effective treatment. Optimal procedures have not been established for the second transplantation in this setting, however. Here we retrospectively analyzed the outcomes of 22 patients with aplastic anemia, age ≥16 years, who underwent umbilical cord blood transplantation for GF after the first HSCT using the registry database of the Japan Society for Hematopoietic Cell Transplantation. The median age of patients was 36 years (range, 16 to 72 years), and the median time from the first to the second transplant was 77 days (range, 29 to 1061 days). The cumulative incidence of neutrophil engraftment at day 60 post-transplantation was 45.5% (95% confidence interval [CI], 23.6% to 65.0%). With a median follow-up of 50 months, the 4-year overall survival (OS) was 38.5% (95% CI, 18.4% to 58.5%). Mycofenolate mofetil-based graft-versus-host disease prophylaxis demonstrated greater neutrophil recovery than prophylaxis with calcineurin inhibitor alone or methotrexate-based prophylaxis (66.7% versus 37.5%; P = .04). The use of such conditioning regimens as fludarabine + melphalan or cyclophosphamide + low-dose total body irradiation was associated with better engraftment (58.3% versus 30%; P = .05) and better 4-year OS (55.6% versus 20%; P = .05) than other regimens. Although further investigation is needed, umbilical cord blood could be an effective and promising option for stem cell source for urgent second transplantation in patients with aplastic anemia who develop GF after the first HSCT.
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Affiliation(s)
- Yasushi Onishi
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan.
| | - Takehiko Mori
- Division of Hematology, Keio University School of Medicine, Tokyo, Japan
| | - Shinichi Kako
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hideo Koh
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Tadakazu Kondo
- Department of Hematology/Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Takeshi Kobayashi
- Division of Hematology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiromasa Yabe
- Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Toshihiro Miyamoto
- Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Kato
- Division of Hematology/Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Nakao
- Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Hirohito Yamazaki
- Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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4
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Cesaro S, Peffault de Latour R, Tridello G, Pillon M, Carlson K, Fagioli F, Jouet JP, Koh MBC, Panizzolo IS, Kyrcz-Krzemien S, Maertens J, Rambaldi A, Strahm B, Blaise D, Maschan A, Marsh J, Dufour C. Second allogeneic stem cell transplant for aplastic anaemia: a retrospective study by the Severe Aplastic Anaemia Working Party of the European Society for Blood and Marrow Transplantation. Br J Haematol 2015; 171:606-14. [PMID: 26304743 DOI: 10.1111/bjh.13650] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 07/23/2015] [Indexed: 12/15/2022]
Abstract
We analysed the outcome of a second allogeneic haematopoietic stem cell transplant (alloHSCT) in 162 patients reported to the European Society for Blood and Marrow Transplantation between 1998 and 2009. Donor origin was a sibling in 110 and an unrelated donor in 52 transplants, respectively. The stem cell source was bone marrow in 31% and peripheral blood in 69% of transplants. The same donor as for the first alloHSCT was used in 81% of transplants whereas a change in the choice of stem cell source was reported in 56% of patients, mainly from bone marrow to peripheral blood. Neutrophil and platelet engraftment occurred in 85% and 72% of patients, after a median time of 15 and 17 days, respectively. Grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD occurred in 21% and 37% of patients, respectively. Graft failure (GF) occurred in 42 patients (26%). After a median follow-up of 3·5 years, the 5-year overall survival (OS) was 60·7%. In multivariate analysis, the only factor significantly associated with a better outcome was a Karnofsky/Lansky score ≥80 (higher OS). We conclude that a second alloHSCT is feasible rescue option for GF in SAA, with a successful outcome in 60% of cases.
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Affiliation(s)
- Simone Cesaro
- Paediatric Haematology and Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Gloria Tridello
- Paediatric Haematology and Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Marta Pillon
- Clinica di Oncoematologia Pediatrica Dipartimento di Pediatria, Padova, Italy
| | | | - Franca Fagioli
- Paediatric Haematology, Regina Margherita Hospital, Torino, Italy
| | - Jean-Pierre Jouet
- Hôpital Claude Huriez Service de Maladies du Sang, Lille Cedex, France
| | - Mickey B C Koh
- St. George's Hospital Department of Haematology, London, UK
| | - Irene Sara Panizzolo
- Paediatric Haematology and Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Johan Maertens
- Dept. of Haematology, University Hospital Gasthuisberg, Leuven, Belgium
| | | | - Brigitte Strahm
- Paediatric Haematology and Oncology, Department of Paediatrics and Adolescent Medicine, University Medical Centre, Freiburg, Germany
| | - Didier Blaise
- Programme de Transplantation &Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Alexei Maschan
- Federal Research Centre for Paediatric Haematology, Oncology and Immunology, Moscow, Russia
| | - Judith Marsh
- Department of Haematological Medicine, King's College Hospital/King's College London, London, UK
| | - Carlo Dufour
- Paediatric Haematology, Institute G. Gaslini, Genova, Italy
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5
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Kudo K, Muramatsu H, Yoshida N, Kobayashi R, Yabe H, Tabuchi K, Kato K, Koh K, Takahashi Y, Hashii Y, Kawano Y, Inoue M, Cho Y, Sakamaki H, Kawa K, Kato K, Suzuki R, Kojima S. Second allogeneic hematopoietic stem cell transplantation in children with severe aplastic anemia. Bone Marrow Transplant 2015; 50:1312-5. [PMID: 26121106 DOI: 10.1038/bmt.2015.153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/27/2015] [Accepted: 05/15/2015] [Indexed: 11/09/2022]
Abstract
The outcome of 55 children with severe aplastic anemia (SAA) who received a second hematopoietic stem cell transplantation (HSCT) was retrospectively analyzed using the registration data of the Japanese Society for Hematopoietic Cell Transplantation. The 5-year overall survival (OS) and failure-free survival (FFS) after the second transplantation were 82.9% (95% confidence interval (CI), 69.7-90.8)) and 81.2% (95% CI, 67.8-89.4), respectively. FFS was significantly better when the interval between the first and second transplantation was >60 days (88.9%; 95% CI, 73.0-95.7) than when it was ⩽60 days (61.4%; 95% CI, 33.3-80.5; P=0.026). All 12 patients who were conditioned with regimens containing fludarabine and melphalan were alive with hematopoietic recovery. These findings justify the recommendation of a second HSCT for children with SAA who have experienced graft failure after first HSCT.
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Affiliation(s)
- K Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - N Yoshida
- Division of Pediatric Hematology/Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - R Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - H Yabe
- Department of Cell Transplantation and Regeneration Medicine, Tokai University School of Medicine, Isehara, Japan
| | - K Tabuchi
- Division of Pediatrics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - K Kato
- Division of Pediatric Hematology and Oncology, Ibaraki Children's Hospital, Mito, Japan
| | - K Koh
- Department of Hematology and Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Y Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Hashii
- Department of Pediatrics, Osaka University Hospital, Suita, Japan
| | - Y Kawano
- Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan
| | - M Inoue
- Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
| | - Y Cho
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
| | - H Sakamaki
- Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - K Kawa
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Japan
| | - K Kato
- Division of Pediatric Hematology/Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - R Suzuki
- Department of Hematopoietic Stem Cell Transplantation, Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Kojima
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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6
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Dynamics of Graft Function Measured by DNA-Technology in a Patient with Severe Aplastic Anemia and Repeated Stem Cell Transplantation. Case Rep Med 2014; 2014:576373. [PMID: 24715914 PMCID: PMC3970357 DOI: 10.1155/2014/576373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/27/2014] [Indexed: 11/30/2022] Open
Abstract
Although bone marrow transplantation (BMT) from an HLA identical sibling is considered as treatment of choice in pediatric patients with severe aplastic anemia (SAA), a significant number of them experience graft failure (GF) after BMT. We report a case of an 8-year-old male patient with SAA who presented with a complicated posttransplant course due to parvovirus B19 infection and GF. A subsequent attempt to support the graft by antithymocyte globulin (ATG) and a peripheral stem cell boost resulted in transitory autologous recovery of hematopoiesis followed by mixed chimerism, supported by donor lymphocyte infusions (DLIs) and finally graft rejection with relapse of SAA. Permanent complete chimerism was achieved by a second BMT. Dynamics of graft function, measured by a single nucleotide polymorphism (SNPs) analysis, are discussed.
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7
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Cotransplantation of haploidentical hematopoietic and umbilical cord mesenchymal stem cells for severe aplastic anemia: successful engraftment and mild GVHD. Stem Cell Res 2013; 12:132-8. [PMID: 24185180 DOI: 10.1016/j.scr.2013.10.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 09/26/2013] [Accepted: 10/01/2013] [Indexed: 02/06/2023] Open
Abstract
Haploidentical hematopoietic stem-cell transplantation (haplo-HSCT) is associated with an increased risk of graft failure and severe graft-versus-host disease (GVHD). Mesenchymal stromal cells (MSCs) have been shown to support in vivo normal hematopoiesis and to display potent immunesuppressive effects. We cotransplanted the culture-expanded third-party donor-derived umbilical cord MSCs (UC-MSCs) in 21 young people with severe aplastic anemia (SAA) undergoing haplo-HSCT without T-cell-depleted. We observed that all patients had sustained hematopoietic engraftment without any adverse UC-MSC infusion-related events. Furthermore, we did not observe any increase in severe aGVHD. These data suggest that UC-MSCs, possibly thanks to their potent immunosuppressive effect on allo-reactive host T lymphocytes escaping the preparative regimen, reduce the risk of graft failure and severe GVHD in haplo-HSCT.
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8
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Horan JT, Carreras J, Tarima S, Camitta BM, Gale RP, Hale GA, Hinterberger W, Marsh J, Passweg JR, Walters MC, Eapen M. Risk factors affecting outcome of second HLA-matched sibling donor transplantations for graft failure in severe acquired aplastic anemia. Biol Blood Marrow Transplant 2009; 15:626-31. [PMID: 19361755 DOI: 10.1016/j.bbmt.2009.01.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Accepted: 01/31/2009] [Indexed: 11/30/2022]
Abstract
We examined transplantation outcomes after a second HLA-matched sibling transplantation for primary (16%) or secondary (84%) graft failure in 166 patients with severe acquired aplastic anemia (AA). Two-thirds of these patients has a performance score < 90. In most cases (88%), the same donor was used for both transplants, for both transplantations, and 84% of the second transplantations used bone marrow grafts. We identified 2 prognostic factors: intertransplantation interval (surrogate for primary graft failure and early secondary graft failure) and performance status. Shorter intertransplantation interval (<or= 3 months) and poor performance score (< 90) at second transplantation were associated with high mortality. In patients with a performance score of 90% to 100%, the 8-year probability of overall survival (OS) after second transplantation <or= 3 and > 3 months from first transplantation was 56% and 76%, respectively. The corresponding probabilities in patients with lower performance scores were 33% and 61%. The predominant cause of failure after second transplantation was nonengraftment (in 72 of 166 patients), most commonly in patients with primary or early secondary graft failure (51 of 72; 71%). Our data indicate that novel approaches, including conditioning regimens with greater immunosuppression, should be explored for these patients.
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Affiliation(s)
- John T Horan
- Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia 30322, USA.
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9
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Fang B, Li N, Song Y, Li J, Zhao RC, Ma Y. Cotransplantation of haploidentical mesenchymal stem cells to enhance engraftment of hematopoietic stem cells and to reduce the risk of graft failure in two children with severe aplastic anemia. Pediatr Transplant 2009; 13:499-502. [PMID: 18673358 DOI: 10.1111/j.1399-3046.2008.01002.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
MSC have been suggested to be the precursor cells in the bone marrow stroma that provide a scaffold and promote hematopoiesis. They have therefore been suggested to enhance engraftment after autologous and allogeneic HSC transplantation. In patients undergoing transplantation, MSC infusion was shown to be safe and to enhance engraftment of HSC, as well as to reduce the incidence of both acute and chronic GVHD. We cotransplanted haploidentical AMSC with HLA-identical sibling-matched PBSC in two pediatric patients with refractory SAA after primary or secondary graft failure. At present, the two patients are more than two yr after cotransplantation without any treatment, transfusion-independent and in good condition. Thus, cotransplantation of MSC might enhance engraftment of HSC in patients regrafted for graft failure.
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Affiliation(s)
- Baijun Fang
- Henan Tumor Hospital, Henan Institute of Haematology, Zhengzhou, China
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10
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Kim DY, Kim DK, Kim SY, Kim SJ, Han DG, Baek HJ, Kook H, Hwang TJ. Second allogeneic hematopoietic stem cell transplantation in children to overcome graft failure or relapse after initial transplant. KOREAN JOURNAL OF PEDIATRICS 2006. [DOI: 10.3345/kjp.2006.49.12.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Dong-Yeon Kim
- Department of Pediatrics, Chonnam National University Medical School Chonnam National University Hwasun Hospital, Blood & Marrow Transplantation Center, Korea
| | - Do Kyun Kim
- Department of Pediatrics, Chonnam National University Medical School Chonnam National University Hwasun Hospital, Blood & Marrow Transplantation Center, Korea
| | - Soo Young Kim
- Department of Pediatrics, Chonnam National University Medical School Chonnam National University Hwasun Hospital, Blood & Marrow Transplantation Center, Korea
| | - Seok Joo Kim
- Department of Pediatrics, Chonnam National University Medical School Chonnam National University Hwasun Hospital, Blood & Marrow Transplantation Center, Korea
| | - Dong Gyun Han
- Department of Pediatrics, Chonnam National University Medical School Chonnam National University Hwasun Hospital, Blood & Marrow Transplantation Center, Korea
| | - Hee Jo Baek
- Department of Pediatrics, Chonnam National University Medical School Chonnam National University Hwasun Hospital, Blood & Marrow Transplantation Center, Korea
| | - Hoon Kook
- Department of Pediatrics, Chonnam National University Medical School Chonnam National University Hwasun Hospital, Blood & Marrow Transplantation Center, Korea
| | - Tai-Ju Hwang
- Department of Pediatrics, Chonnam National University Medical School Chonnam National University Hwasun Hospital, Blood & Marrow Transplantation Center, Korea
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Trakhtman P, Shipicina I, Balashov D, Scvortsova J, Dishlevaja Z, Blagonravova O, Maschan A. CD34-enriched peripheral stem cells infusion for graft insufficiency treatment in a pediatric patient with severe aplastic anemia after allogeneic bone marrow transplantation. Bone Marrow Transplant 2004; 34:465-6. [PMID: 15220960 DOI: 10.1038/sj.bmt.1704599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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