HLA-mismatched microtransplantation for relapsed or refractory acute myeloid leukemia as a bridge to allogeneic hematopoietic stem cell transplantation

Sidharthan, Neeraj; Fuchs, Ephraim J.; Unni, Manoj; Mony, Ullas; Boyella, Pavankumar; Prabhu, Raghuveer; Ganapathy, Rema; Shenoy, Veena; Vidyadharan, Geeta

doi:10.1038/s41409-019-0761-4

Cited by 5 publications

(1 citation statement)

References 6 publications

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“…Further studies are in consequence advised to focus on the ways in which MST can be combined with more effective targeted drugs, as well as improvement of techniques of modi ed stem cells for elderly patients to prolong survival. (25,26) A large number of allogeneic hematopoietic stem cells were repeatedly infused, where no immunosuppressants were used before and after MST treatment. Therefore, it is particularly important to observe and identify GVHD, although the most of patients did not have a stable and high percentage of chimerism of donor cells.…”

Section: Discussionmentioning

confidence: 99%

Stem Cells Micro-transplantation in Elderly Patients Aged Over 70 With Acute Myeloid Leukemia: a Multicenter, Prospective, Non-interventional Study

Guo

et al. 2021

Preprint

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BackgroundThe treatment outcomes of elderly patients aged over 70 with acute myeloid leukemia (AML) have been very disappointing. In comparison, our designed HLA-mismatched hematopoietic stem cell micro-transplantation (MST) has achieved such encouraging treatment results in AML patients as might warrant further investigations of the outcomes of MST for the above mentioned patients. MethodsOne hundred and eleven patients aged 70-88 years were enrolled. Eighty patients were assigned to the high-risk MST or standard MST group according to high-risk prognostic factors. The other thirty-one patients were assigned to either the chemotherapy group or support group. After receiving induction chemotherapy with cytarabine and anthracycline, patients who achieved complete remission (CR) were given another 2 cycles of post-remission therapy with cytarabine. Each chemotherapy regimen was followed by donor stem cell infusion in the MST groups. ResultMST achieved an encouragingly high CR rate in patients (63.8%), even in high-risk patients (54%). It was significantly higher than that in the chemotherapy alone group. The 1-year overall survival (OS) of MST patients was 57.7% and was 68.6% in the high-risk and standard group, respectively, whereas the OS was only 37.3% in the chemotherapy group. The severe infection rate was 36% and 54% in MST and chemotherapy group. No GVHD was observed in MST patients. A larger updated T cell clones was observed in MST patients by T cell receptor repertoire analysis with a Next Generation Sequencing methodology. ConclusionsThese results suggested that MST is a safe and practical treatment regimen conducive to a longer-term survival for AML patients at a highly advanced age.

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Section: Discussionmentioning

confidence: 99%

Stem Cells Micro-transplantation in Elderly Patients Aged Over 70 With Acute Myeloid Leukemia: a Multicenter, Prospective, Non-interventional Study

Guo

et al. 2021

Preprint

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Comparative study of micro‐transplantation from HLA fully mismatched unrelated and partly matched related donors in acute myeloid leukemia

Guo

et al. 2020

American J Hematol

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Micro‐transplantation (MST) by chemotherapy, combined with granulocyte colony‐stimulating factor‐mobilized peripheral blood stem cell (GPBSC) infusion, from an HLA partial matched related donor has shown some encouraging effective therapy for acute myeloid leukemia (AML). However, the outcome of human leukocyte antigen (HLA) fully mismatched unrelated donor‐derived MST in such patients is still unknown. In the present study, we compared the efficacy of HLA fully mismatched unrelated donor‐derived MST, and partly matched related donor‐derived MST, in AML of 126 patients from two centers in China, These patients, aged 16 to 65 years, were given three or four courses of MST, which consisted of a high dosage cytarabine followed by GPBSC from unrelated donor or related donor. There was a statistically significant difference in 3‐year leukemia‐free survival (LFS) and 3‐year overall survival (OS) between the unrelated and the related group. The non‐treatment‐related mortality (NRM) rates of patients, and other adverse complications, were no different in the two groups. In conclusion, unrelated donor‐derived MST is believed to be a safe treatment, with efficacy similar to or higher than related donor‐derived MST. This result provides support for the potential of MST for expanding the donor selection. However, the specific mechanism of action needs further study.

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Expert consensus on microtransplant for acute myeloid leukemia in elderly patients -report from the international microtransplant interest group

Ai¹,

Chao²,

Rizzieri³

et al. 2023

Heliyon

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HLA-mismatched microtransplantation for relapsed or refractory acute myeloid leukemia as a bridge to allogeneic hematopoietic stem cell transplantation

Cited by 5 publications

References 6 publications

Stem Cells Micro-transplantation in Elderly Patients Aged Over 70 With Acute Myeloid Leukemia: a Multicenter, Prospective, Non-interventional Study

Stem Cells Micro-transplantation in Elderly Patients Aged Over 70 With Acute Myeloid Leukemia: a Multicenter, Prospective, Non-interventional Study

Comparative study of micro‐transplantation from HLA fully mismatched unrelated and partly matched related donors in acute myeloid leukemia

Expert consensus on microtransplant for acute myeloid leukemia in elderly patients -report from the international microtransplant interest group

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