Handgretinger R, Lang P, Schumm M, Pfeiffer M, Gottschling S, Demirdelen B, Bader P, Kuci S, Klingebiel T, Niethammer D
Children's University Hospital, Department of Hematology/Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
Ann N Y Acad Sci. 2001 Jun;938:340-57; discussion 357-8. doi: 10.1111/j.1749-6632.2001.tb03602.x.
Thirty-eight children with high-risk hematological malignancies underwent transplantation with megadoses of peripheral mobilized CD34+ cells from haploidentical parents (n = 24) or from matched unrelated donors (n = 14). The CD34+ cells were isolated to a purity of > 98% using magnetic-activated cell sorting. This high purity was associated with an almost complete depletion of T lymphocytes. No pharmacological prophylaxis for graft-versus-host disease (GvHD) was used, and significant primary GvHD was not seen. A final engraftment was seen in all patients. Sixteen patients are alive and disease-free with a median follow-up of 24 months. The immunological reconstitution was faster in the patients transplanted with CD34+ stem cells from the haploidentical donors compared to the matched unrelated donors, and the transplantation of large numbers of haploidentical CD34+ stem cells seems to be superior to that of the matched unrelated donors. The phenotypical and functional analysis of the immune reconstitution provided some insights into the biology of transplantation of highly purified CD34+ cells. In this article, we summarize our current results with the transplantation of highly purified stem cells and discuss possible implications for further antileukemic post-transplant therapeutic strategies.
38例高危血液系统恶性肿瘤患儿接受了来自单倍体相合父母（n = 24）或匹配的无关供者（n = 14）的超大剂量外周血动员CD34+细胞移植。使用磁珠分选法将CD34+细胞分离至纯度> 98%。这种高纯度与T淋巴细胞几乎完全清除相关。未使用移植物抗宿主病（GvHD）的药物预防措施，且未观察到明显的原发性GvHD。所有患者均实现最终植入。16例患者存活且无疾病，中位随访时间为24个月。与匹配的无关供者相比，接受单倍体相合供者的CD34+干细胞移植的患者免疫重建更快，大量单倍体相合CD34+干细胞移植似乎优于匹配的无关供者。免疫重建的表型和功能分析为高纯度CD34+细胞移植生物学提供了一些见解。在本文中，我们总结了高纯度干细胞移植的当前结果，并讨论了对移植后进一步抗白血病治疗策略的可能影响。
