Hematopoietic stem cell transplantation activity in China 2019: a report from the Chinese Blood and Marrow Transplantation Registry Group

Xu, Lei; Lu, Peihua; Wu, Depei; Sun, Zimin; Liu, Qifa; Han, Mingzhe; Zhang, Xi; Song, Yongping; Song, Xianmin; Hu, Jianda; Huang, He; Lai, Yongrong; Wan, Dingming; Chen, Jing; Li, Chunfu; Xia, Linghui; Wang, Jingbo; Liu, Dai‐Hong; Huang, Xiao‐Jun

doi:10.1038/s41409-021-01431-6

Cited by 60 publications

(51 citation statements)

References 19 publications

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“…In China, haploidentical donors have been the largest source of allogeneic HSCT donors since 2013 and their prevalence among all donors increased to more than 60% in 2019. Other types of donors include MSDs (21.7%), unrelated donors (12.8%) and cord blood donors (5.4%) (62).…”

Section: The Beijing Protocolmentioning

confidence: 99%

T-Cell-Replete Versus ex vivo T-Cell-Depleted Haploidentical Haematopoietic Stem Cell Transplantation in Children With Acute Lymphoblastic Leukaemia and Other Haematological Malignancies

Kleinschmidt

Yanir

et al. 2021

Front. Pediatr.

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Allogeneic haematopoietic stem cell transplantation (HSCT) represents a potentially curative option for children with high-risk or refractory/relapsed leukaemias. Traditional donor hierarchy favours a human leukocyte antigen (HLA)-matched sibling donor (MSD) over an HLA-matched unrelated donor (MUD), followed by alternative donors such as haploidentical donors or unrelated cord blood. However, haploidentical HSCT (hHSCT) may be entailed with significant advantages: besides a potentially increased graft-vs.-leukaemia effect, the immediate availability of a relative as well as the possibility of a second donation for additional cellular therapies may impact on outcome. The key question in hHSCT is how, and how deeply, to deplete donor T-cells. More T cells in the graft confer faster immune reconstitution with consecutively lower infection rates, however, greater numbers of T-cells might be associated with higher rates of graft-vs.-host disease (GvHD). Two different methods for reduction of alloreactivity have been established: in vivo T-cell suppression and ex vivo T-cell depletion (TCD). Ex vivo TCD of the graft uses either positive selection or negative depletion of graft cells before infusion. In contrast, T-cell-repleted grafts consisting of non-manipulated bone marrow or peripheral blood grafts require intense in vivo GvHD prophylaxis. There are two major T-cell replete protocols: one is based on post-transplantation cyclophosphamide (PTCy), while the other is based on anti-thymocyte globulin (ATG; Beijing protocol). Published data do not show an unequivocal benefit for one of these three platforms in terms of overall survival, non-relapse mortality or disease recurrence. In this review, we discuss the pros and cons of these three different approaches to hHSCT with an emphasis on the significance of the existing data for children with acute lymphoblastic leukaemia.

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Section: The Beijing Protocolmentioning

confidence: 99%

T-Cell-Replete Versus ex vivo T-Cell-Depleted Haploidentical Haematopoietic Stem Cell Transplantation in Children With Acute Lymphoblastic Leukaemia and Other Haematological Malignancies

Kleinschmidt

Yanir

et al. 2021

Front. Pediatr.

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“…Third, ATG was administered to prevent GVHD in all HID HSCT recipients. Ninety-four percent of the conditioning regimens for HID HSCT contained ATG ( Xu et al., 2021 ). Thus, the predicted value of our model should be further confirmed in patients receiving HID HSCT with PTCY for GVHD prophylaxis and in those receiving identical sibling donor HSCT.…”

Section: Discussionmentioning

confidence: 99%

“…Human leukocyte antigen (HLA)-haploidentical related donors (HIDs) have become important donors. Such donors account for 60% of all allo-HSCT donors in China ( Xu et al., 2021 ) and account for 42% of allo-HSCT family donors in Europe ( Passweg et al., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

A Predicted Model for Refractory/Recurrent Cytomegalovirus Infection in Acute Leukemia Patients After Haploidentical Hematopoietic Stem Cell Transplantation

Shen

Hong

Wang

et al. 2022

Front. Cell. Infect. Microbiol.

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ObjectiveWe aimed to establish a model that can predict refractory/recurrent cytomegalovirus (CMV) infection after haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT).MethodsConsecutive acute leukemia patients receiving HID HSCT were enrolled (n = 289). We randomly selected 60% of the entire population (n = 170) as the training cohort, and the remaining 40% comprised the validation cohort (n = 119). Patients were treated according to the protocol registered at https://clinicaltrials.gov (NCT03756675).ResultsThe model was as follows: Y = 0.0322 × (age) – 0.0696 × (gender) + 0.5492 × (underlying disease) + 0.0963 × (the cumulative dose of prednisone during pre-engraftment phase) – 0.0771 × (CD34+ cell counts in graft) – 1.2926. The threshold of probability was 0.5243, which helped to separate patients into high- and low-risk groups. In the low- and high-risk groups, the 100-day cumulative incidence of refractory/recurrent CMV was 42.0% [95% confidence interval (CI), 34.7%–49.4%] vs. 63.7% (95% CI, 54.8%–72.6%) (P < 0.001) for total patients and was 50.5% (95% confidence interval (CI), 40.9%–60.1%) vs. 71.0% (95% CI, 59.5%–82.4%) (P = 0.024) for those with acute graft-versus-host disease. It could also predict posttransplant mortality and survival.ConclusionWe established a comprehensive model that could predict the refractory/recurrent CMV infection after HID HSCT.Clinical Trial Registrationhttps://clinicaltrials.gov, identifier NCT03756675.

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“…Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the most important curative method for acute leukemia (AL), which can significantly improve the long-term survival [ 1 , 2 ]. Human leukocyte antigen (HLA) haploidentical related donors (HIDs) have become one of the most important donors, which accounted for the proportion at 42% among allo-HSCT from family donors in Europe [ 3 ], and accounted for the proportion at 60% among all of the allo-HSCT in China [ 4 ].…”

Section: Introdutionmentioning

confidence: 99%

A comprehensive model to predict severe acute graft-versus-host disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation

et al. 2022

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Background Acute graft-versus-host disease (aGVHD) remains the major cause of early mortality after haploidentical related donor (HID) hematopoietic stem cell transplantation (HSCT). We aimed to establish a comprehensive model which could predict severe aGVHD after HID HSCT. Methods Consecutive 470 acute leukemia patients receiving HID HSCT according to the protocol registered at https://clinicaltrials.gov (NCT03756675) were enrolled, 70% of them (n = 335) were randomly selected as training cohort and the remains 30% (n = 135) were used as validation cohort. Results The equation was as follows: Probability (grade III–IV aGVHD) = $$\frac{1}{{1 + \exp \left( { - \,{\text{Y}}} \right)}}$$ 1 1 + exp - Y , where Y = –0.0288 × (age) + 0.7965 × (gender) + 0.8371 × (CD3 + /CD14 + cells ratio in graft) + 0.5829 × (donor/recipient relation) − 0.0089 × (CD8 + cell counts in graft) − 2.9046. The threshold of probability was 0.057392 which helped separate patients into high- and low-risk groups. The 100-day cumulative incidence of grade III–IV aGVHD in the low- and high-risk groups was 4.1% (95% CI 1.9–6.3%) versus 12.8% (95% CI 7.4–18.2%) (P = 0.001), 3.2% (95% CI 1.2–5.1%) versus 10.6% (95% CI 4.7–16.5%) (P = 0.006), and 6.1% (95% CI 1.3–10.9%) versus 19.4% (95% CI 6.3–32.5%) (P = 0.017), respectively, in total, training, and validation cohort. The rates of grade III–IV skin and gut aGVHD in high-risk group were both significantly higher than those of low-risk group. This model could also predict grade II–IV and grade I–IV aGVHD. Conclusions We established a model which could predict the development of severe aGVHD in HID HSCT recipients.

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Hematopoietic stem cell transplantation activity in China 2019: a report from the Chinese Blood and Marrow Transplantation Registry Group

Cited by 60 publications

References 19 publications

T-Cell-Replete Versus ex vivo T-Cell-Depleted Haploidentical Haematopoietic Stem Cell Transplantation in Children With Acute Lymphoblastic Leukaemia and Other Haematological Malignancies

T-Cell-Replete Versus ex vivo T-Cell-Depleted Haploidentical Haematopoietic Stem Cell Transplantation in Children With Acute Lymphoblastic Leukaemia and Other Haematological Malignancies

A Predicted Model for Refractory/Recurrent Cytomegalovirus Infection in Acute Leukemia Patients After Haploidentical Hematopoietic Stem Cell Transplantation

A comprehensive model to predict severe acute graft-versus-host disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation

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