Haploidentical Stem Cell Transplantation With Dual Source of Cells and Post-Transplant Cyclophosphamide

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-01-31 DOI:10.1002/cam4.70541

Ana Marcela Rojas Fonseca-Hial, Katya Parisio, Jose Salvador Rodrigues de Oliveira

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引用次数: 0

Abstract

Background

Dual sources of cells (DSC) with peripheral blood stem cell apheresis (PBSC) and surgical bone marrow (BM) for haploidentical hematopoietic cell transplantation (Hid-HCT) are used in China and some Asian countries. The experience of the Baltimore group for haploidentical transplant with post-transplant cyclophosphamide (PT-Cy) and reduced-intensity-conditioning (RIC) regimen used BM as a source of hematopoietic stem cells.

Methods

We retrospectively analyzed 64 Hid-HCT with DSC and PT-Cy, RIC (n = 57), or myeloablative-conditioning (MAC) (n = 7), from two public health Brazilian centers, with a median follow-up of 23.3 months (6.7–45.4).

Results

The 49 malignant patients were 27/46 (58.7%) beyond the first remission or with no complete response, and three patients did not complete disease status evaluation before transplant. Eight of 62 patients (12.9%) had grade 2 or more Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI), and two patients had no HCT-CI classified. Cytomegalovirus (CMV) viremia occurred in 26 of 57 (45.6%). The cumulative incidence of 100-day grade III-IV acute GVHD was 12.3% (7/57), with a 95% confidence interval (CI) of 3.8% and 20.8%, and 2-year moderate or severe chronic GVHD was 21.1% (11/52; 95% CI, 10.1%–32.3%). The 2-year relapses were 24.5% for malignant disease (12/49; 95% CI, 12.4%–36.5%). The 2-year overall survival (OS) probability was 54.7% (35/64; 95% CI, 42.5%–66.9%). Benign diseases achieve 2-year OS in 73.3% (11/15; 95% CI, 51%–95.7%) of the patients. The HCT-CI were significant in multivariate analyses for DFS (p = 0.002) and OS in uni- and multivariate analyses (both p < 0.001). The number of CD34⁺ cells by apheresis collection was significant in multivariate analysis for DFS (p = 0.039).

Conclusion

Hid-HCT using PT-Cy, DSC, and RIC is a safe option for benign and malignant diseases.

Abstract Image

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单倍体干细胞移植与双细胞来源和移植后环磷酰胺。

背景：在中国和一些亚洲国家，采用外周血干细胞分离（PBSC）和手术骨髓（BM）进行单倍体造血细胞移植（Hid-HCT）的双来源细胞（DSC）。巴尔的摩组采用移植后环磷酰胺（PT-Cy）和降低强度调节（RIC）方案进行单倍体移植的经验使用BM作为造血干细胞的来源。方法：我们回顾性分析了来自巴西两个公共卫生中心的64例hdi - hct伴DSC和PT-Cy、RIC （n = 57）或骨髓清除调节（MAC）（n = 7），中位随访时间为23.3个月（6.7-45.4）。结果：49例恶性患者中有27/46（58.7%）患者超过首次缓解或未完全缓解，3例患者在移植前未完成疾病状态评估。62例患者中有8例（12.9%）具有2级或以上的造血细胞移植特异性合并症指数（HCT-CI）， 2例患者没有HCT-CI分类。57例中有26例（45.6%）发生巨细胞病毒血症。100天III-IV级急性GVHD的累积发病率为12.3%(7/57)，95%可信区间（CI）分别为3.8%和20.8%，2年中重度慢性GVHD为21.1% (11/52；95% ci, 10.1%-32.3%)。恶性肿瘤2年复发率为24.5% (12/49；95% ci, 12.4%-36.5%)。2年总生存（OS）概率为54.7% (35/64；95% ci, 42.5%-66.9%)。良性疾病2年生存率为73.3% (11/15；95% CI, 51%-95.7%)。HCT-CI在DFS的多变量分析中显著（p = 0.002）， OS在单变量和多变量分析中显著(单采收集的p +细胞在DFS的多变量分析中显著（p = 0.039）。结论：采用PT-Cy、DSC和RIC的hct治疗良恶性疾病是一种安全的选择。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.