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Premium Selective T cell‐depleted haploidentical hematopoietic stem cell transplantation for relapsed/refractory neuroblastoma
Liu Anthony P. Y.,
Lee Pamela P. W.,
Kwok Janette S. Y.,
Leung Rock Y. Y.,
Chiang Alan K. S.,
Ha ShauYin,
Cheuk Daniel K. L.,
Chan Godfrey C. F.
Publication year2018
Publication title
pediatric transplantation
Resource typeJournals
Abstract Relapsed/refractory NB carries a bleak outcome, warranting novel treatment options. HaploHSCT induces a graft‐versus‐ NB effect via natural killer cell alloreactivity. Review of patients with relapsed/refractory NB who underwent haplo HSCT with ex vivo T‐cell depletion in our unit from 2013 through 2018. Ten patients were identified (male=5; median age at haplo HSCT =6.45 y, range: 3.49‐11.02 y). Indications were relapsed in 7 and refractoriness in 3; disease status at haplo HSCT was CR in 2, PR in 6, and PD in 2. All patients received peripheral blood stem cell grafts after ex vivo T‐cell depletion ( CD 3/ CD 19‐depletion=1; TCR ‐αβ/ CD 19‐depletion=4; CD 3/ CD 45 RA ‐depletion=4; and TCR ‐αβ/ CD 45 RA ‐depletion=1). Conditioning regimens were fludarabine‐based. Neutrophils engrafted on median D + 10 (range: D + 9 to +13), and platelets engrafted (≥20 × 10 9 /L) on median D + 8 (range: D + 5 to D + 14). Early T‐ and NK ‐cell recovery were evident. Of the 10 patients, acute rejection developed in 1 (who died of PD despite rescue HSCT ), and 1 died of sepsis before engraftment; 8 experienced full donor‐chimerism post‐ HSCT . Among the 8, 6 experienced CR , 1 died of PD , and 1 died of pulmonary hypertensive crisis before evaluation. At publication, 4 were in remission (2.8, 7.4, 28.5, and 58.9 months). No significant Gv HD occurred. Haplo HSCT with selective ex vivo T‐cell depletion may be a safe and useful salvage strategy for relapsed/refractory NB .
Subject(s)astrobiology , biology , chemotherapy , cyclophosphamide , ex vivo , fludarabine , gastroenterology , genetics , hematopoietic stem cell transplantation , immune system , immunology , in vivo , medicine , microbiology and biotechnology , refractory (planetary science) , stem cell , t cell , transplantation
SCImago Journal Rank0.457

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