van Gorkom Gwendolyn, Billen Evy, Van Elssen Catharina, van Gelder Michel, Bos Gerard
Division of Hematology Department of Internal Medicine GROW School for Oncology and Developmental Biology Maastricht University Medical Center Maastricht The Netherlands.
EJHaem. 2021 May 26;2(3):440-448. doi: 10.1002/jha2.203. eCollection 2021 Aug.
The aim of this study was to describe real-world data on outcomes of T cell replete haploidentical hematopoietic stem cell transplantation (HSCT) after the introduction of this modality in a single center and to compare them with different donor types.
Outcomes of 30 consecutive patients with hematological malignancies that received T cell replete haploidentical HSCT with posttransplantation cyclophosphamide (PTCY) from 2016 to 2018 in our center were analyzed and compared to the outcome of human leukocyte antigen (HLA)-related and unrelated matched donor HSCT ( = 97) and to a historical cohort of T cell depleted haploidentical HSCT ( = 11).
One year graft-versus-host-free, relapse-free survival in haploidentical HSCT was comparable with other donor types (haplo 40%, matched related donor [MRD] 33%, matched unrelated donor [MUD] 25%, = 0.55). Non relapse mortality was high in haploidentical HSCT (50%), mostly due to infectious complications. However, relapse rates were only 3%, and OS and progression-free survival after 1 year were 47% and thereby also similar to HLA-matched HSCT in our center (MRD 53%, MUD 48%).
Our data show that T cell replete haploidentical HSCT has similar outcomes to HLA identical HSCT after introduction in our center. More strict adaptation on infection prevention was a crucial aspect of our learning curve. Overall, this type of transplantation is a feasible option when lacking an HLA-identical donor. This option has advantages over an unrelated donor as it brings less logistical challenges than MUD transplantations.
本研究旨在描述在单一中心引入单倍体相合造血干细胞移植（HSCT）后其结局的真实世界数据，并将其与不同供体类型进行比较。
分析了2016年至2018年在本中心接受含移植后环磷酰胺（PTCY）的T细胞充足的单倍体相合HSCT的30例连续血液系统恶性肿瘤患者的结局，并与人类白细胞抗原（HLA）相关和无关匹配供体HSCT（n = 97）的结局以及T细胞去除的单倍体相合HSCT的历史队列（n = 11）进行比较。
单倍体相合HSCT的1年无移植物抗宿主病、无复发生存率与其他供体类型相当（单倍体相合40%，匹配相关供体[MRD] 33%，匹配无关供体[MUD] 25%，P = 0.55）。单倍体相合HSCT的非复发死亡率较高（50%），主要是由于感染并发症。然而，复发率仅为3%，1年后的总生存率和无进展生存率分别为47%，因此也与本中心HLA匹配的HSCT相似（MRD 53%，MUD 48%）。
我们的数据表明，在本中心引入后，T细胞充足的单倍体相合HSCT与HLA相同的HSCT具有相似的结局。更严格地预防感染是我们经验积累过程中的一个关键方面。总体而言，当缺乏HLA相同的供体时，这种类型的移植是一种可行的选择。与无关供体相比，这种选择具有优势，因为它比MUD移植带来的后勤挑战更少。
