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- W4252005504 abstract "A novel approach to HLA mismatched/haploidentical blood and marrow hematopoietic stem cell transplantation. Peking University researchers developed a novel approach to HLA-mismatched/haploidentical transplantation without in vitro T cell depletion. More than 831 cases of haploidentical transplantation have been fulfilled and the promising results have been achieved. Huang et al reported 171 patients underwent transplantation with this protocol, all patients achieved hematopoietic recovery. There was no significant association between the extent of HLA disparity and the time of myeloid or platelet recovry. Multivariate analysis indicated that the number of CD34+ cells (<2.19×106/kg) in allografts, and advanced disease stage were independently associated with platelet engraftment. While in pediatric patients only infused CD34+ cells/kg was significantly associated with platelet engraftment. At days 100, the cumulative incidence was 55.0% for grade II-IV aGVHD, and 23.1% for grade III-IV aGVHD. While cGVHD 44.67%, with 21.3% for limited and 23.3% for extensive. In patients under 14 years old, the cumulative incidence of aGVHD of grade II-IV was 57.2%, and 13.8% for grade III-IV. While cGVHD 56.7% for total and 29.5% for extensive. No associations of HLA disparity with incidence and severity of GVHD were found. KIR ligand mismatch and a higher dose of CD56bright NK cells (41.9×106/kg) in the allografts are associated with high incidence of aGVHD, while a higher CD56dim/CD56bri NK cell ratio (more than 8.0) in allografts was correlated with a decreased risk of III-IV aGVHD. The 3-year probability of relapse in the standard-risk group was 11.9% and 24.3% for AML and ALL and that in high-risk group was 20.2% and 48.5% for AML and ALL, respectively. The advanced disease status, Higher CD4/CD8 in G-BM and delayed lymphocyte recovery at day 30 post transplantation are correlated with increased relapse rate. While, a higher CD56dim/CD56bri NK cell ratio (more than 8.0) was correlated with a decreased rate of relapse. Modified DLI can be used to treat relapse of patients after the protocol. The TRM on day 100 in the standard- and high-risk groups was 6.8% and 5.9% for AML and 6.9% and 25.9% for ALL, respectively. The 3-year probability of LFS for AML was 70.7% and 55.9% and for ALL was 59.7% and 24.8% in the standard-risk and high-risk groups, respectively." @default.
- W4252005504 created "2022-05-12" @default.
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- W4252005504 date "2010-02-01" @default.
- W4252005504 modified "2023-09-27" @default.
- W4252005504 title "Unmanipulated HLA-Mismatched/Haploidentical Blood And Marrow Hematopoietic Stem Cell Transplantation" @default.
- W4252005504 doi "https://doi.org/10.1016/j.bbmt.2009.12.347" @default.
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