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αβ/CD19 阴性同种异体造血干细胞移植治疗儿童急性白血病:移植物中 γδ T 细胞含量增加是否有保护作用?

αβ /CD19 -depleted haploidentical stem cell transplantation for children with acute leukemia: Is there a protective effect of increased γδ T-cell content in the graft?

机构信息

Division of Pediatric Hematology and Oncology, Sheba Medical Center, The Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Pediatr Transplant. 2023 Aug;27(5):e14531. doi: 10.1111/petr.14531. Epub 2023 May 1.

Abstract

BACKGROUND

Haploidentical hematopoietic stem cell transplantation (HSCT) with depletion of αβ T cells and CD19 B cells has emerged as a viable alternative to traditional donors for treating acute leukemia in children. As the use of this innovative approach continues to grow and more experience is gained, it is essential to identify and comprehend the key factors that contribute to successful transplantation and improved outcomes.

METHODS

We conducted a retrospective analysis of single-center data from 27 children with acute lymphoblastic leukemia and 11 children with acute myeloid leukemia who underwent haploidentical HSCT with depletion of αβ T cells and CD19 B cells between the years 2013 and 2020.

RESULTS

Engraftment was successful in 34 out of 38 patients (90%). The 5-year overall survival and event-free survival rates were 51% and 42%, respectively. There were no cases of grade III-IV acute graft-versus-host disease, and only two patients developed chronic graft-versus-host disease. Patients with a higher content of γδ T cells in the graft demonstrated a longer event-free survival.

CONCLUSIONS

αβ /CD19 -depleted haploidentical hematopoietic stem cell transplantation can offer long-term remission for children with acute leukemia with minimal graft-versus-host disease.

摘要

背景

去除αβ T 细胞和 CD19 B 细胞的单倍体造血干细胞移植(HSCT)已经成为治疗儿童急性白血病的一种可行的传统供体替代方案。随着这种创新方法的应用不断增加并获得更多经验,确定并理解有助于成功移植和改善结果的关键因素至关重要。

方法

我们对 2013 年至 2020 年间在单中心接受去除αβ T 细胞和 CD19 B 细胞的单倍体 HSCT 的 27 例急性淋巴细胞白血病和 11 例急性髓细胞白血病患儿进行了回顾性分析。

结果

38 例患者中的 34 例(90%)成功植入。5 年总生存率和无事件生存率分别为 51%和 42%。无 III-IV 级急性移植物抗宿主病病例,仅有 2 例发生慢性移植物抗宿主病。移植中γδ T 细胞含量较高的患者无事件生存率更长。

结论

去除αβ/CD19 的单倍体造血干细胞移植可使急性白血病患儿获得长期缓解,且移植物抗宿主病发生率低。

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