Haploidentical hematopoietic stem cell transplantation with unmanipulated granulocyte colony stimulating factor mobilized marrow and blood grafts

Chang, Ying‐Jun; Huang, Xiao‐Jun

doi:10.1097/moh.0b013e3283582322

Cited by 41 publications

(45 citation statements)

References 41 publications

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“…More recently, Di Bartolomeo et al 4 used a modified protocol (Italian protocol) that was developed by our group, 96,97 and they achieved promising results in terms of the engraftment rate (93 ± 0.1% and 75 ± 0.2% for neutrophil and platelet, respectively), incidence of GVHD (24±0.2% and 17±0.3% for acute and chronic GVHD, respectively) and survival (45±6% for the 3-year probability of OS). These encouraging outcomes observed by Di Bartolomeo et al 4 and ourselves 1,92 suggest that G-CSF and pharmacological agent therapy may offset GVHD risk from multiple HLA disparities in both Caucasian and Chinese individuals.…”

Section: Comparison Of the Underlying Mechanisms And Clinical Outcomementioning

confidence: 58%

“…1,3,4,66,99 However, currently, there is no well-recognized standard haploidentical transplant protocol because each is based on the combination of different strategies with unique advantages and disadvantages (Tables 1 and 2; Figure 1). 3,8,12,24,64 Therefore, investigating novel combinations of strategies that can be used to overcome HLA barriers is a necessary future research direction to establish improved haploidentical protocols.…”

Section: Future Perspectivesmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] However, the success of haploidentical SCT is hindered by the host and donor T-cell response to allogeneic HLA molecules resulting in unacceptably high incidences of GVHD and graft rejection. The questions of how allografts can avoid rejection from a haploidentical recipient immune system and how normal host tissues can avoid attack by donor alloreactive immune cells have intrigued immunologists and hematologists alike for nearly 30 years.…”

Section: Introductionmentioning

confidence: 99%

“…5,[8][9][10][11][12][13][14] A great deal of work had been conducted to devise strategies to overcome this immunological barrier. These include ex-vivo graft T-cell depletion (TCD) 8,15,16 and CD3/CD19 depletion, 17 immune tolerance induced by G-CSF, 1,4,[18][19][20][21][22][23] and post transplantation CY for tolerance induction. 21,24 In this review, we summarize the recent advances in haploidentical SCT and focus on the mechanisms underlying the strategies that can be used to overcome the HLA barrier.…”

Section: Introductionmentioning

confidence: 99%

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Haploidentical SCT: the mechanisms underlying the crossing of HLA barriers

Huang

2014

Bone Marrow Transplant

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Research on the different mechanisms for crossing HLA barriers has progressed over the past 10 years. General outlines have come into view for a solution to this issue and are often presented as 'haploidentical SCT' immunology. In this review, we discuss several mechanisms that have recently been described in ex vivo and in vivo settings that can either avoid GVHD or promote hematopoietic reconstitution in haploidentical settings. The host and donor T-cell responses to allogeneic HLA molecules are a fundamental obstacle to the successful application of haploidentical transplantation, which results in unacceptably high incidences of GVHD and graft rejection. Thus, the T-cell response is a central factor in the establishment of a novel haploidentical transplant protocol with superior outcomes.

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Section: Comparison Of the Underlying Mechanisms And Clinical Outcomementioning

confidence: 58%

Section: Future Perspectivesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Haploidentical SCT: the mechanisms underlying the crossing of HLA barriers

Huang

2014

Bone Marrow Transplant

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“…Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative therapy for hematological malignancies (1); however, the outcome of treatment is closely associated with the patient's condition during transplantation. Before the procedure, the recipients need to receive multiple courses of chemotherapy, m y e l o a b l a t i v e c o n d i t i o n i n g , a n d p r o p h y l a c t i c immunosuppressive therapy against graft versus host disease (GVHD), resulting in an impaired immune function and agranulocytosis.…”

Section: Introductionmentioning

confidence: 99%

Impact of pre-transplant pulmonary infection developed in horizontal laminar flow unit on the outcome of subsequent allogeneic hematopoietic stem cell transplantation

Chang

et al. 2016

J. Thorac. Dis.

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Background: So far, there is very little literature on how pre-transplant pulmonary infection developed in horizontal laminar flow unit (HLFU) affects outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods: A retrospective analysis was performed on allo-HSCT recipients who were diagnosed with pretransplant pulmonary infection developed in HLFU between January 2012 and December 2012. Various tests were analyzed to evaluate the overall survival (OS) and pulmonary infection rate after allo-HSCT.Results: Among 317 patients who received allo-HSCT from related donors, 7 cases of human leukocyte antigen (HLA)-haploidentical transplantation reported a fever, cough, and other symptoms before transplantation. Chest radiography findings showed pulmonary infection, and the C-reactive protein (CRP) level was higher than normal, which confirmed pulmonary infection (incidence rate 2.21%). The Breslow test suggested that the early survival rate was lower in the group with pre-transplant pulmonary infection than in the group without pre-transplant pulmonary infection (OS: 28.4 vs. 42.4 months; P=0.023); the early survival rate was lower in patients with a pulmonary infection accompanied by bilateral pleural effusion than in patients without pleural effusion (OS: 1.5 vs. 36.3 months; P=0.010). In the first month after transplantation, the difference in the CD4CD45RO+CD45RA-and CD4CD45RO-CD45RA+ between the groups with and without pre-transplant pulmonary infection was statistically significant (P<0.05). Patients with pre-transplant pulmonary infection who survived >3 years had a higher rate of pulmonary infection in the first 2 months after allo-HSCT than those without pre-transplant pulmonary infection [100% (5/5 patients) vs. 38.1%(118/310); χ 2 =5.542, P=0.019].Conclusions: Development of pre-transplant pulmonary infection in the HLFU in patients with hematological malignancies who receive HLA-haploidentical HSCT is associated with an increased risk of recurrent pulmonary infection in the early period after transplantation; however, there is no impact on patients' long-term survival rate.

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Monocytic and promyelocytic myeloid‐derived suppressor cells may contribute to G‐CSF‐induced immune tolerance in haplo‐identical allogeneic hematopoietic stem cell transplantation

Zhao

et al. 2014

American J Hematol

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We investigated the effects of granulocyte colony-stimulating factor (G-CSF) on monocytic (M), promyelocytic (P), and granulocytic (G) myeloid-derived suppressor cells (MDSCs) both in bone marrow and peripheral blood of 20 healthy donors and the association of MDSCs subgroups with acute and chronic graft-versus-host disease (aGvHD/cGvHD) in 62 patients who underwent haplo-identical allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients who received a higher absolute counts of M-MDSCs or P-MDSCs exhibited lower incidence of grade II-IV aGvHD (P = 0.001; P = 0.031) and extensive cGvHD (P = 0.011; P = 0.021). In the multivariate analysis, absolute counts of MDSCs in allografts emerged as independent factors that reduced the occurrence of grade II-IV aGvHD (M-MDSCs: HR = 0.087, 95% CI = 0.020-0.381, P = 0.001; P-MDSCs: HR = 0.357, 95% CI = 0.139-0.922, P = 0.033) and extensive cGvHD (M-MDSCs: HR = 0.196, 95% CI = 0.043-0.894, P = 0.035; P-MDSCs: HR = 0.257, 95% CI = 0.070-0.942, P = 0.04). Delayed M-MDSC reconstitution was associated with aGvHD onset. The 3-year cumulative incidence of transplant related mortality and relapse, 3-year probability of disease-free survival, and overall survival did not differ significantly between these subgroups. Our results suggested that G-CSF-induced immune tolerance may be mediated by M/P-MDSCs in allo-HSCT.

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Haploidentical hematopoietic stem cell transplantation with unmanipulated granulocyte colony stimulating factor mobilized marrow and blood grafts

Abstract: Unmanipulated HBMT is a reliable protocol. New strategies should be investigated to decrease the incidences of GVHD and relapse. Novel mobilization regimens such as AMD3100 alone or G-CSF+AMD3100 for allograft engineering may improve transplant outcomes following HBMT.

Cited by 41 publications

References 41 publications

Haploidentical SCT: the mechanisms underlying the crossing of HLA barriers

Haploidentical SCT: the mechanisms underlying the crossing of HLA barriers

Impact of pre-transplant pulmonary infection developed in horizontal laminar flow unit on the outcome of subsequent allogeneic hematopoietic stem cell transplantation

Monocytic and promyelocytic myeloid‐derived suppressor cells may contribute to G‐CSF‐induced immune tolerance in haplo‐identical allogeneic hematopoietic stem cell transplantation

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