[Clinical Study of Haploidentical Peripheral Blood Stem Cell T...

This study was aimed to explore the efficacy and associated complications of haploidentical peripheral blood stem cell transplantation (hi-PBSCT) without ex vivo T-cell depletion in treatment of hematological malignancies. 15 high-risk patients received HLA 1-3 loci (A, B, or DRB1) mismatched hi-PBSCT. The modified Bu/Cy or TBI/Cy regimen was used for preconditioning of patients. The anti-thymocyte globulin, cyclosporin A, methotrexate and mycophenolate mofetil were used for GVHD prophylaxis. 4 cases were administrated with anti-CD25 monclonal antibody. G-CSF-mobilized peripheral blood stem cells were infused, with the median number of infused nucleated cells was 8.16 (3.92 - 10.86) x 10(8)/kg and that of CD34(+) cells was 4.51 (1.27 - 5.95) x 10(6)/kg. The results showed that the rapid engraftment was observed in all cases. The median times of neutrophil recovery >/= 0.5 x 10(9)/L and platelet recovery >/= 20 x 10(9)/L were 14 (11 - 19) and 22 (11 - 52) days after transplantation respectively. 6 cases developed acute GVHD of grade I-II, and 2 cases experienced chronic extensive GVHD. Infection within 100 days after hi-PBSCT was documented in all cases. 8 cases were subjected to bacterial infection, and six got cytomegalovirus infection. Relapse occurred in five cases. Overall survival of patients was 46.7% (7/15), with a median follow-up of 213 (42 - 589) days. In conclusion, hi-PBSCT provides an effective alternative treatment for high-risk patients in lack of matched donors, and to reduce the high transplantation-related mortality.