About this item:

29 Views | 4 Downloads

Subjects:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Hematology
  • Immunology
  • Transplantation
  • Thalassemia
  • Reduced-intensity conditioning
  • Hematopoietic stem cell transplant
  • Unrelated donor
  • STEM-CELL TRANSPLANTATION
  • BONE-MARROW-TRANSPLANTATION
  • UMBILICAL-CORD BLOOD
  • NONMALIGNANT DISEASES
  • REGIMEN
  • HEMOGLOBINOPATHIES
  • EXPERIENCE
  • OUTCOMES
  • STANDARD
  • GRAFT

Unrelated Donor Transplantation in Children with Thalassemia using Reduced-Intensity Conditioning: The URTH Trial

Show all authors Show less authors

Tools:

Journal Title:

Biology of Blood and Marrow Transplantation

Volume:

Volume 24, Number 6

Publisher:

, Pages 1216-1222

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Allogeneic hematopoietic stem cell transplantation (HSCT) can cure transfusion-dependent thalassemia (TDT). In a multicenter trial we investigated the efficacy of reduced-intensity conditioning (RIC) before unrelated donor (URD) HSCT in children with TDT. Thirty-three children, ages 1 to 17 years, received bone marrow (BM) or umbilical cord blood (UCB) allografts. Median time to neutrophil engraftment was 13 days (range, 10 to 25) and 24 days (range, 18 to 49) and platelet engraftment 23 days (range, 12 to 46) and 50 days (range, 31 to 234) after BM and UCB allografts, respectively. With a median follow-up of 58 months (range, 7 to 79), overall and thalassemia-free survival was 82% (95% CI,.64% to.92%) and 79% (95% CI,.6% to.9%), respectively. The cumulative incidence of grades II to IV acute graft-versus-host disease (GVHD) after BM and UCB allografts was 24% and 44%; the 2-year cumulative incidence of chronic extensive GVHD was 29% and 21%, respectively; 71% of BM and 91% of UCB recipients discontinued systemic immunosuppression by 2 years. Six patients who had Pesaro risk class 2 (n = 5) and class 3 (n = 1) died of GVHD (n = 3), viral pneumonitis (n = 2) and pulmonary hemorrhage (n = 1). Outcomes after this RIC compared favorably with URD HSCT outcomes for TDT and supported engraftment in 32 of 33 patients. Efforts to reduce GVHD and infectious complications are being pursued further.

Copyright information:

© 2018 The American Society for Blood and Marrow Transplantation

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Creative Commons License

Export to EndNote