Allogeneic peripheral blood stem cell transplantation from two- or three-loci-mismatched related donors in adult Japanese patients with high-risk hematologic malignancies

S. Yamasaki, Y. Ohno, S. Taniguchi, T. Yoshida, S. Hayashi, H. Ogawa, C. Shimazaki, S. Takahashi, M. Kasai, A. Wake, M. Nishimura, K. Tokunaga, H. Gondo, Y. Takaue, M. Harada, Shin Mineishi

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Abstract

With the increasing frequency of haploidentical transplantation, it is becoming more important to establish the degree of HLA mismatch that can be accepted. We retrospectively analyzed clinical data of 50 adult Japanese patients with high-risk hematologic malignancies who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from two- or three-loci-mismatched related donors with HLA class I and II gene disparities in the graft-versus-host direction. They were treated at 20 transplant centers between 1996 and 2002. In all, 18 patients received unmanipulated PBSC, while 32 received purified CD34+ blood cells. Conventional (n = 31) or reduced-intensity (n = 19) conditioning regimens were used. Of the 39 patients (78%) who survived for ≥28 days after transplant, 37 (95%) achieved neutrophil engraftment, while graft failure and rejection occurred in two of 39 (5%) and three of 37 (8%) patients, respectively. Stepwise Cox regression analysis revealed a significantly lower incidence of grades II-IV acute GVHD in patients receiving purified CD34+ cells (hazard ratio 0.32; 95% CI 0.12-0.84; P = 0.022). By 1 year post transplant, 28 patients (56%) had died of transplant-related problems, including infectious complications (30%). Although the number of patients is small, our data suggest that transplant-related problems, particularly infectious complications, are major obstacles to the success of this therapy.

Original languageEnglish (US)
Pages (from-to)279-289
Number of pages11
JournalBone Marrow Transplantation
Volume33
Issue number3
DOIs
StatePublished - Feb 1 2004

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Peripheral Blood Stem Cell Transplantation
Hematologic Neoplasms
Tissue Donors
Transplants
MHC Class I Genes
MHC Class II Genes
Graft Rejection
Blood Cells
Neutrophils
Transplantation
Regression Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Yamasaki, S. ; Ohno, Y. ; Taniguchi, S. ; Yoshida, T. ; Hayashi, S. ; Ogawa, H. ; Shimazaki, C. ; Takahashi, S. ; Kasai, M. ; Wake, A. ; Nishimura, M. ; Tokunaga, K. ; Gondo, H. ; Takaue, Y. ; Harada, M. ; Mineishi, Shin. / Allogeneic peripheral blood stem cell transplantation from two- or three-loci-mismatched related donors in adult Japanese patients with high-risk hematologic malignancies. In: Bone Marrow Transplantation. 2004 ; Vol. 33, No. 3. pp. 279-289.
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abstract = "With the increasing frequency of haploidentical transplantation, it is becoming more important to establish the degree of HLA mismatch that can be accepted. We retrospectively analyzed clinical data of 50 adult Japanese patients with high-risk hematologic malignancies who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from two- or three-loci-mismatched related donors with HLA class I and II gene disparities in the graft-versus-host direction. They were treated at 20 transplant centers between 1996 and 2002. In all, 18 patients received unmanipulated PBSC, while 32 received purified CD34+ blood cells. Conventional (n = 31) or reduced-intensity (n = 19) conditioning regimens were used. Of the 39 patients (78{\%}) who survived for ≥28 days after transplant, 37 (95{\%}) achieved neutrophil engraftment, while graft failure and rejection occurred in two of 39 (5{\%}) and three of 37 (8{\%}) patients, respectively. Stepwise Cox regression analysis revealed a significantly lower incidence of grades II-IV acute GVHD in patients receiving purified CD34+ cells (hazard ratio 0.32; 95{\%} CI 0.12-0.84; P = 0.022). By 1 year post transplant, 28 patients (56{\%}) had died of transplant-related problems, including infectious complications (30{\%}). Although the number of patients is small, our data suggest that transplant-related problems, particularly infectious complications, are major obstacles to the success of this therapy.",
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Yamasaki, S, Ohno, Y, Taniguchi, S, Yoshida, T, Hayashi, S, Ogawa, H, Shimazaki, C, Takahashi, S, Kasai, M, Wake, A, Nishimura, M, Tokunaga, K, Gondo, H, Takaue, Y, Harada, M & Mineishi, S 2004, 'Allogeneic peripheral blood stem cell transplantation from two- or three-loci-mismatched related donors in adult Japanese patients with high-risk hematologic malignancies', Bone Marrow Transplantation, vol. 33, no. 3, pp. 279-289. https://doi.org/10.1038/sj.bmt.1704342

Allogeneic peripheral blood stem cell transplantation from two- or three-loci-mismatched related donors in adult Japanese patients with high-risk hematologic malignancies. / Yamasaki, S.; Ohno, Y.; Taniguchi, S.; Yoshida, T.; Hayashi, S.; Ogawa, H.; Shimazaki, C.; Takahashi, S.; Kasai, M.; Wake, A.; Nishimura, M.; Tokunaga, K.; Gondo, H.; Takaue, Y.; Harada, M.; Mineishi, Shin.

In: Bone Marrow Transplantation, Vol. 33, No. 3, 01.02.2004, p. 279-289.

Research output: Contribution to journalArticle

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T1 - Allogeneic peripheral blood stem cell transplantation from two- or three-loci-mismatched related donors in adult Japanese patients with high-risk hematologic malignancies

AU - Yamasaki, S.

AU - Ohno, Y.

AU - Taniguchi, S.

AU - Yoshida, T.

AU - Hayashi, S.

AU - Ogawa, H.

AU - Shimazaki, C.

AU - Takahashi, S.

AU - Kasai, M.

AU - Wake, A.

AU - Nishimura, M.

AU - Tokunaga, K.

AU - Gondo, H.

AU - Takaue, Y.

AU - Harada, M.

AU - Mineishi, Shin

PY - 2004/2/1

Y1 - 2004/2/1

N2 - With the increasing frequency of haploidentical transplantation, it is becoming more important to establish the degree of HLA mismatch that can be accepted. We retrospectively analyzed clinical data of 50 adult Japanese patients with high-risk hematologic malignancies who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from two- or three-loci-mismatched related donors with HLA class I and II gene disparities in the graft-versus-host direction. They were treated at 20 transplant centers between 1996 and 2002. In all, 18 patients received unmanipulated PBSC, while 32 received purified CD34+ blood cells. Conventional (n = 31) or reduced-intensity (n = 19) conditioning regimens were used. Of the 39 patients (78%) who survived for ≥28 days after transplant, 37 (95%) achieved neutrophil engraftment, while graft failure and rejection occurred in two of 39 (5%) and three of 37 (8%) patients, respectively. Stepwise Cox regression analysis revealed a significantly lower incidence of grades II-IV acute GVHD in patients receiving purified CD34+ cells (hazard ratio 0.32; 95% CI 0.12-0.84; P = 0.022). By 1 year post transplant, 28 patients (56%) had died of transplant-related problems, including infectious complications (30%). Although the number of patients is small, our data suggest that transplant-related problems, particularly infectious complications, are major obstacles to the success of this therapy.

AB - With the increasing frequency of haploidentical transplantation, it is becoming more important to establish the degree of HLA mismatch that can be accepted. We retrospectively analyzed clinical data of 50 adult Japanese patients with high-risk hematologic malignancies who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from two- or three-loci-mismatched related donors with HLA class I and II gene disparities in the graft-versus-host direction. They were treated at 20 transplant centers between 1996 and 2002. In all, 18 patients received unmanipulated PBSC, while 32 received purified CD34+ blood cells. Conventional (n = 31) or reduced-intensity (n = 19) conditioning regimens were used. Of the 39 patients (78%) who survived for ≥28 days after transplant, 37 (95%) achieved neutrophil engraftment, while graft failure and rejection occurred in two of 39 (5%) and three of 37 (8%) patients, respectively. Stepwise Cox regression analysis revealed a significantly lower incidence of grades II-IV acute GVHD in patients receiving purified CD34+ cells (hazard ratio 0.32; 95% CI 0.12-0.84; P = 0.022). By 1 year post transplant, 28 patients (56%) had died of transplant-related problems, including infectious complications (30%). Although the number of patients is small, our data suggest that transplant-related problems, particularly infectious complications, are major obstacles to the success of this therapy.

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