1
|
Torres Canizales J, Ferreras C, Pascual A, Alonso L, Regueiro A, Plaza M, Pérez Hurtado JM, Benito A, Couselo JM, Fuster JL, Díaz-Almirón M, Bueno D, Mozo Y, Gómez López A, Vicario JL, Balas A, Sisinni L, Díaz de Heredia C, Pérez-Martínez A. Haploidentical transplantation in pediatric non-malignant diseases: A retrospective analysis on behalf of the Spanish Group for Hematopoietic Transplantation (GETH). Eur J Haematol 2020; 106:196-204. [PMID: 33084101 DOI: 10.1111/ejh.13536] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Describe the GETH haploidentical stem cell transplantation (haplo-HSCT) activity in non-malignant disease (NMDs). METHODS We retrospectively analyzed data from children with NMDs who underwent haplo-HSCT. RESULTS From January 2001 to December 2016, 26 pediatric patients underwent 31 haplo-HSCT through ex vivo T cell-depleted (TCD) graft platforms or post-transplantation cyclophosphamide (PT-Cy) at 7 Spanish centers. Five cases employed unmanipulated PT-Cy haplo-HSCT, 16 employed highly purified CD34+ cells, and 10 employed ex vivo TCD grafts manipulated either with CD3+ CD19+ depletion, TCRαβ+ CD19+ selection or naive CD45RA+ T-cell depletion. Peripheral blood stem cells were the sole source for patients following TCD haplo-HSCT, and bone marrow was the source for one PT-Cy haplo-HSCT. The most common indications for transplantation were primary immunodeficiency disorders (PIDs), severe aplastic anemia, osteopetrosis, and thalassemia. The 1-year cumulative incidence of graft failure was 27.4%. The 1-year III-IV acute graft-versus-host disease (GvHD) and 1-year chronic GvHD rates were 34.6% and 16.7%, respectively. The 2-year overall survival was 44.9% for PIDs, and the 2-year graft-versus-host disease-free and relapse-free survival rate was 37.6% for the other NMDs. The transplantation-related mortality at day 100 was 30.8%. CONCLUSION Although these results are discouraging, improvements will come if procedures are centralized in centers of expertise.
Collapse
Affiliation(s)
- Juan Torres Canizales
- La Paz University Hospital, Madrid, Spain.,La Paz Institute of Health Research, IdiPAZ, Paz University Hospital, Madrid, Spain
| | - Cristina Ferreras
- La Paz University Hospital, Madrid, Spain.,La Paz Institute of Health Research, IdiPAZ, Paz University Hospital, Madrid, Spain
| | | | | | | | - Mercedes Plaza
- Virgen de la Arrixaca University Clinical Hospital, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | | | | | - José M Couselo
- University of Santiago Clinical Hospital, Santiago de Compostela, Spain
| | - José L Fuster
- Virgen de la Arrixaca University Clinical Hospital, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | | | | | | | | | - José L Vicario
- Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | - Antonio Balas
- Centro de Transfusión de la Comunidad de Madrid, Madrid, Spain
| | | | | | - Antonio Pérez-Martínez
- La Paz University Hospital, Madrid, Spain.,La Paz Institute of Health Research, IdiPAZ, Paz University Hospital, Madrid, Spain.,Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| |
Collapse
|