Rodriguez-Torres Jackeline C, Pando-Caciano Alejandra, Future Benigno, Guerrero Marco E, Saldarriaga Tatiana, Pereda María A, Murillo-Vizcarra Sergio A
Servicio de Trasplante de Progenitores Hematopoyéticos, Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
Sub Unidad de Investigación e Innovación Tecnológica, Instituto Nacional de Salud del Niño San Borja, Lima, Perú.
J Pediatr Hematol Oncol. 2025 May 1;47(4):161-168. doi: 10.1097/MPH.0000000000003021. Epub 2025 Mar 31.
Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) using TCR αβ+/CD19+ depletion provides an alternative treatment for patients with high-risk (HR) leukemias without a matched donor, especially in developing nations with limited donor registries. We present the outcomes of 36 patients <16 years with HR leukemia who underwent haplo-HSCT with TCR αβ + /CD19 + depletion between 2018 and 2022 at a referral center in Peru. Survival probabilities and cumulative incidence functions were calculated using the Kaplan-Meier method. Patients were followed for a median of 17.38 months (range: 2.34 to 60.36 mo). The 5-year overall survival (OS), 5-year event-free survival (EFS), and non-relapse mortality rates were 72.1%, 72.2%, and 16.7%, respectively. The incidence of relapse for the entire group was 11.1%. Acute graft versus host disease (GvHD) was observed in 36.1% of the patients, with only 2.8% experiencing grade III-IV acute GvHD. No patients developed chronic GvHD. Among all patients, CMV reactivations were observed in 27.78%, HHV-6 reactivations in 33.33%, and ADV or BK virus reactivations in 16.67%. Our study suggests that haplo-HSCT with TCR αβ+/CD19+ depletion is a safe and effective treatment for HR pediatric leukemias. Adopting this approach in major transplant centers throughout the country could improve outcomes for this group of patients.
使用TCRαβ+/CD19+去除法的单倍体相合造血干细胞移植（haplo-HSCT）为没有匹配供体的高危（HR）白血病患者提供了一种替代治疗方法，特别是在供体登记有限的发展中国家。我们报告了2018年至2022年期间在秘鲁一家转诊中心接受TCRαβ + /CD19 +去除法单倍体相合造血干细胞移植的36例16岁以下HR白血病患者的治疗结果。使用Kaplan-Meier方法计算生存概率和累积发病率函数。患者的中位随访时间为17.38个月（范围：2.34至60.36个月）。5年总生存率（OS）、5年无事件生存率（EFS）和非复发死亡率分别为72.1%、72.2%和16.7%。整个组的复发率为11.1%。36.1%的患者观察到急性移植物抗宿主病（GvHD），只有2.8%的患者经历III-IV级急性GvHD。没有患者发生慢性GvHD。在所有患者中，27.78%观察到巨细胞病毒（CMV）重新激活，33.33%观察到人类疱疹病毒6型（HHV-6）重新激活，16.67%观察到腺病毒（ADV）或BK病毒重新激活。我们的研究表明，使用TCRαβ+/CD19+去除法的单倍体相合造血干细胞移植是治疗HR儿童白血病的一种安全有效的方法。在全国主要移植中心采用这种方法可以改善这组患者的治疗结果。
