TcRαβ-depleted haploidentical transplantation results in adult acute leukemia patients

KAYNAR L., Demir K., Turak E. E., Öztürk Ç. P., ZARARSIZ G., GÖNEN Z. B., ...More

HEMATOLOGY, vol.22, no.3, pp.136-144, 2017 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 22 Issue: 3
  • Publication Date: 2017
  • Doi Number: 10.1080/10245332.2016.1238182
  • Journal Name: HEMATOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.136-144
  • Keywords: alpha beta T cell depletion, haploidentical transplantation, immune reconstitution
  • Istanbul Medipol University Affiliated: No


Introduction: The use of αβ+ T-cell-depleted grafts is a novel approach to prevent graft failure, graft-versus-host disease (GVHD), and non-relapse mortality (NRM) in patients undergoing haploidentical hematopoietic stem cell transplantation. Patient and method: Thirty-four patients with acute leukemia and lacking a match donor were treated with αβ T-cell-depleted allografts from haploidentical family donors. A total of 24 patients had acute myeloid leukemia (AML) and 10 had acute lymphoblastic leukemia. 84.4% of patients were in the high-risk group, and 55.9% were not in remission. The preparative regimen included thiotepa, melphalan, fludarabine, and anti-thymocyte globulin-Fresenius. Grafts were peripheral blood stem cells engineered by TcR-alpha/beta depletion. Results: Neutrophil and platelet engraftment was achieved on days +12 (range, 10.5–15) and +11 (range, 10–12). All but three patients were engrafted with full donor chimerism. Grade III-IV acute GVHD occurred in two (5.9%) patients and chronic GVHD in two (6.1%). Disease-free survival and overall survival were 42 and 54% at 1 year, respectively. AML as disease type (HR: 4.87, 95% CI: 1.50–15.87) and mother as donor (HR: 1.05, 95% CI: 1.00–1.11) were found to be independent risk factors on patient survival. Mortality and NRM in the first 100 days were 5 of 34 (14.7%) and 4 of 34 (11.7%). Relapse was the main cause of death (56.3%). T-cell reconstitution appears to be faster than that reported in published data with CD3/CD19-depleted grafts. Conclusion: αβ T-cell-depleted haploidentical transplantation may be a good alternative for high-risk patients if there are no human leukocyte antigen matched donors.