TY - JOUR
T1 - Safe and Efficacious Allogeneic Bone Marrow Transplantation for Nonmalignant Disorders Using Partial T Cell Depletion and No Posttransplantation Graft-Versus-Host-Disease Prophylaxis
AU - Elhasid, Ronit
AU - Arush, Myriam Ben
AU - Zaidman, Irena
AU - Leiba, Ronit
AU - Barak, Ayelet Ben
AU - Postovsky, Sergey
AU - Haddad, Nuhad
AU - Katz, Tami
AU - Pollack, Shimon
AU - Sami, Ivanka
AU - Gidoni, Osnat
AU - Rubin, Dina
AU - Mandel, Hanna
AU - Attias, Dina
AU - Reisner, Yair
AU - Etzioni, Amos
AU - Rowe, Jacob M.
PY - 2007/3
Y1 - 2007/3
N2 - In an attempt to abrogate the deleterious effects of graft-versus-host disease (GVHD), allogeneic transplantation for nonmalignant diseases was performed using high-dose CD34-cell infusion, partial T cell depletion, and no posttransplantation GVHD prophylaxis. Between 1998 and 2004, 16 patients with matched related donors were treated. Median age was 1.5 years (range, 5 months-18 years). The conditioning regimen consisted of busulphan 16 mg/kg, cyclophosphamide 200 mg/kg, antithymocyte globulin (ATG) 25 mg/kg, and fludarabine 200 mg/m2. No GVHD prophylaxis was given. High doses of CD34 cells, positively selected by immunomagnetic beads, were infused at a median dose of 10.7 × 106 CD34/kg (range, 7.4-50 × 106). A total of 1 × 105/kg T cells were given. All patients engrafted, with no graft rejections. All were alive and well at a median of 37 months posttransplantation (range, 18-89 months). Only 1 patient developed chronic GVHD. No episodes of severe infection occurred during or after transplantation. Immunologic reconstitution with CD3/CD4 T cells > 200/μL was observed at a median of 117 days and that with naive T cells (CD4/CD45RA) at a median of 188 days posttransplantation. Our findings suggest that allogeneic transplantation from a matched family donor for nonmalignant disorders can be successfully performed using high doses of CD34 cells, moderate T cell depletion, and no posttransplantation immunosuppression.
AB - In an attempt to abrogate the deleterious effects of graft-versus-host disease (GVHD), allogeneic transplantation for nonmalignant diseases was performed using high-dose CD34-cell infusion, partial T cell depletion, and no posttransplantation GVHD prophylaxis. Between 1998 and 2004, 16 patients with matched related donors were treated. Median age was 1.5 years (range, 5 months-18 years). The conditioning regimen consisted of busulphan 16 mg/kg, cyclophosphamide 200 mg/kg, antithymocyte globulin (ATG) 25 mg/kg, and fludarabine 200 mg/m2. No GVHD prophylaxis was given. High doses of CD34 cells, positively selected by immunomagnetic beads, were infused at a median dose of 10.7 × 106 CD34/kg (range, 7.4-50 × 106). A total of 1 × 105/kg T cells were given. All patients engrafted, with no graft rejections. All were alive and well at a median of 37 months posttransplantation (range, 18-89 months). Only 1 patient developed chronic GVHD. No episodes of severe infection occurred during or after transplantation. Immunologic reconstitution with CD3/CD4 T cells > 200/μL was observed at a median of 117 days and that with naive T cells (CD4/CD45RA) at a median of 188 days posttransplantation. Our findings suggest that allogeneic transplantation from a matched family donor for nonmalignant disorders can be successfully performed using high doses of CD34 cells, moderate T cell depletion, and no posttransplantation immunosuppression.
KW - CD34 cells
KW - Matched related donor
KW - Nonmalignant disease
KW - Peripheral stem cell transplantation
KW - T cell depletion
UR - http://www.scopus.com/inward/record.url?scp=33847011704&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2006.10.028
DO - 10.1016/j.bbmt.2006.10.028
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C2 - 17317586
AN - SCOPUS:33847011704
SN - 1083-8791
VL - 13
SP - 329
EP - 338
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 3
ER -