کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8429980 | 1546228 | 2018 | 36 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Haploidentical Stem Cell Transplantation for Refractory/Relapsed Neuroblastoma
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کلمات کلیدی
موضوعات مرتبط
علوم زیستی و بیوفناوری
بیوشیمی، ژنتیک و زیست شناسی مولکولی
تحقیقات سرطان
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چکیده انگلیسی
Pediatric patients with refractory or relapsed metastatic neuroblastoma (NBL) have a poor prognosis despite autologous stem cell transplantation (SCT). Allogeneic SCT from a haploidentical donor has a remarkable alloreactive effect in patients with leukemia; thus, we evaluated this approach in children with very high-risk NBL. We analyzed data from 2 prospective phase I/II trials. A total of 26 patients with refractory (nâ=â5), metastatic relapsed (nâ=â20), or locally relapsed MYCN-positive (nâ=â1) NBL received a median of 17âÃâ106/kg T/B cell-depleted CD34+ stem cells with 68âÃâ103/kg residual T cells and 107âÃâ106/kg natural killer cells. The conditioning regimen comprised melphalan, fludarabine, thiotepa, OKT3, and a short course of mycophenolate mofetil post-transplantation. Engraftment occurred in 96% of the patients. Event-free survival and overall survival at 5 years were 19% and 23%, respectively. No transplantation-related mortality was observed, and the single death was due to progression/subsequent relapse. The median duration of follow-up was 8.1 years. Patients in complete remission before SCT had a significantly better prognosis than those with residual tumor load (Pâ<â.01). All patients with progressive disease before SCT relapsed within 1 year. Grade II and grade III acute graft-versus-host disease (GVHD) occurred in 31% and 12% of the patients, respectively. Chronic limited and extensive GVHD occurred in 28% and 10%, respectively. Our data indicate that haploidentical SCT is a feasible treatment option that can induce long-term remission in some patients with NBL with tolerable side effects, and may enable the development of further post-transplantation therapeutic strategies based on the donor-derived immune system.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Biology of Blood and Marrow Transplantation - Volume 24, Issue 5, May 2018, Pages 1005-1012
Journal: Biology of Blood and Marrow Transplantation - Volume 24, Issue 5, May 2018, Pages 1005-1012
نویسندگان
Toni Illhardt, Jacek Toporski, Tobias Feuchtinger, Dominik Turkiewicz, Heiko-Manuel Teltschik, Martin Ebinger, Carl-Philipp Schwarze, Ursula Holzer, Holger N. Lode, Michael H. Albert, Bernd Gruhn, Christian Urban, Josefina H. Dykes, Oliver Teuffel,