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学科主题: 临床医学
题名:
Total Body Irradiation and Cyclophosphamide Plus Antithymocyte Globulin Regimen Is Well Tolerated and Promotes Stable Engraftment as a Preparative Regimen before T Cell-Replete Haploidentical Transplantation for Acute Leukemia
作者: Fu, Haixia; Xu, Lanping; Liu, Daihong; Liu, Kaiyan; Zhang, Xiaohui; Chen, Huan; Chen, Yuhong; Han, Wei; Wang, Yu; Wang, Jingzhi; Wang, Fengrong; Huang, Xiaojun
关键词: Total body irradiation ; Busulfan ; Antithymocyte globulin ; T cell-replete ; Haploidentical ; Hematopoietic stem cell transplantation
刊名: BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
发表日期: 2014-08-01
DOI: 10.1016/j.bbmt.2014.04.012
卷: 20, 期:8, 页:1176-1182
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Hematology ; Immunology ; Transplantation
研究领域[WOS]: Hematology ; Immunology ; Transplantation
关键词[WOS]: VERSUS-HOST-DISEASE ; BONE-MARROW-TRANSPLANTATION ; HLA-MISMATCHED/HAPLOIDENTICAL BLOOD ; ACUTE LYMPHOBLASTIC-LEUKEMIA ; DONOR LYMPHOCYTE INFUSION ; ACUTE MYELOID-LEUKEMIA ; HIGH-RISK ; BUSULFAN ; RELAPSE ; MALIGNANCIES
英文摘要:

We compared total body irradiation (TBI, 700 cGy)/cyclophosphamide (Cy, 3.6 g/m(2))/simustine (250 mg/m(2)) plus antithymocyte globulin (ATG) (TBI/Cy plus ATG) with cytarabine (8 g/m(2))/i.v. busulfan (Bu, 9.6 mg/kg)/Cy (3.6 g/m2)/simustine (250 mg/m(2)) plus ATG (modified Bu/Cy plus ATG) as preparative therapy in Tcell-replete haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for acute leukemia. From August 2009 to August 2013, 38 consecutive patients using TBI/Cy plus ATG regimen for T cell-replete haplo-HSCT (TBI group) at our center were eligible, which contained 28 high-risk and 10 standard-risk patients. A nested case-control study was designed. Seventy-seven patients using modified Bu/Cy plus ATG regimen (Bu group) were randomly selected in a 1 to 3:1 ratio matching for age, disease and status, year of HSCT (+/- 2 years), and length of follow-up. Only 1 graft failure occurred in the TB! group. The incidence and time of neutrophil and platelet engraftment were comparable between the 2 groups. Severe grades III/IV graft-versus-host disease was observed in 13.4% of Bu group and only 2.6% of TBI group (P = .083). More toxicity of the liver (37.7% versus 10.5%; P = .002) and more hemorrhagic cystitis occurred in the Bu group (49.3% versus 23.7%, P = .008). Diarrhea was more common in the TB! group (44.7% versus 22.1%; P = .031). No significant differences were found in the 2-year incidences of relapse (26.5% for TBI group versus 32.3% for Bu group, P = .742), 1-year transplant-related mortality (12.6% versus 16.2%, P = .862), 2-year overall survival (60.2% versus 57.0%, P = .937), and 2-year incidence of disease-free survival (57.9% versus 56.6%, P = .845) between the 2 groups. We conclude that the TBI/Cy plus ATG regimen seems to be feasible in T cell replete haplo-HSCT, which promotes stable engraftment and a lower incidence of liver toxicity and hemorrhagic cystitis. However, longer follow-up is necessary to determine the late relapse rate and late toxicity. (C) 2014 Published by Elsevier Inc.

语种: 英语
所属项目编号: 81230013 ; Z121107002612035
项目资助者: Key Program of National Natural Science Foundation of China ; Bejing Municipal Science 82 Technology Commission
WOS记录号: WOS:000339464100015
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55806
Appears in Collections:北京大学第二临床医学院_血液科_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Inst Hematol, Beijing 100044, Peoples R China

Recommended Citation:
Fu, Haixia,Xu, Lanping,Liu, Daihong,et al. Total Body Irradiation and Cyclophosphamide Plus Antithymocyte Globulin Regimen Is Well Tolerated and Promotes Stable Engraftment as a Preparative Regimen before T Cell-Replete Haploidentical Transplantation for Acute Leukemia[J]. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION,2014,20(8):1176-1182.
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