1,721,355 research outputs found
T-cell depletion: From positive selection to negative depletion in adult patients
No full textClinical trials have shown that a strategy for haploidentical transplantation based on the infusion of high numbers of T-cell-depleted hematopoietic progenitor cells and no post-transplant immunosuppression controls graft rejection and GvHD in patients with acute leukemia. Overall, event-free survival compares favorably with reports of transplants using sources of stem cells other than the matched sibling. Current studies are focussing on rebuilding post-transplant immunity to improve clinical outcomes separating GvHD from favourable donor immune responses
Full haplotype mismatched hematopoietic stem cell transplants
No full textClinical outcome in leukemia patients transplanted from one-haplotype mismatched donors has been largely disappointing because of the high incidence of severe graft-vs-host disease in T-replete transplants or high rejection rates in T-cell-depleted transplants
Setting the standard in T-cell-depleted haploidentical transplantation and beyond
No full textMuch progress has been made in the clinical, biological and technical aspects of the T-cell-depleted haploidentical hematopoietic stem cell transplantation (HSCT). Our experience demonstrates that infusing a megadose of extensively T-cell-depleted hematopoietic peripheral blood stem cells after an immuno-myeloablative conditioning regimen in acute leukemia patients ensures sustained engraftment with minimal GvHD without the need of any post-transplant immunosuppressive treatment. Since our first successful pilot study, our efforts have concentrated on developing new conditioning regimens, optimizing the graft processing and improving the post-transplant immunological recovery. The results we have so far achieved in high risk acute leukemia patients show that haploidentical transplantation is now a clinical reality. The present challenge is to reduce post-transplant infectious mortality and several strategies are being tested
Haploidentical haematopoietic stem cell transplantation for acute leukaemia in adults: experience in Europe and the United States.
No full textWork on one haplotype-mismatched transplants has been proceeding for over 20 years all over the world and novel transplant techniques have been developed. Some centres have focused on the conditioning regimens and post transplant immune suppression; others have concentrated on manipulating the graft. Haploidentical transplant modalities are based mainly on high-intensity conditioning regimen, but reduced intensity regimens have recently been introduced. The graft may be a megadose of extensively T cell-depleted or unmanipulated progenitor cells. Excellent engraftment rates are associated with a very low incidence of GVHD- and regimen-related mortality even in patients who are over 50 years old. Overall, event-free survival and transplant-related mortality compare favourably with reports on transplants from sources of stem cells other than the matched sibling. Improvements will come with successful implementation of strategies to accelerate and strengthen post transplant immune reconstitution as well as transplantation of patients in early stage disease
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