[English]  [Pусский]  [中文]  
 
ctt-journal > Subbotina et al. (Abstract)

Subbotina et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract24

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

Contribute a comment

 

Allogeneiс partially mismatched relative hematopoietic stem cell transplantation in children with advanced cancer

Natalia N. Subbotina1, Igor S. Dolgopolov1, Ludmila Y. Grivtsova2, Vasily K. Boyarshinov1, Georgy L. Mentkevich1

1Institute of Pediatric Oncology and Hematology, RCRC Moscow, Russia; 2Laboratory of Immunology and Hematopoiesis, RCRC Moscow, Russia

Correspondence: Natalia N. Subbotina, Institute of Pediatric Oncology and Hematology, 24, Kashirskoye sh., 115478, Moscow, Russia, E-mail: natik-23@spam is badyandex.ru

Abstract

Unrelated full-matched donor searching in Russia is a very difficult option for the majority of pts who need allo-HSCT due to lack of time or/and financial support. Allogeneic non-full-matched HSCT from relatives becomes the only possible treatment option.

Since 2001 48 pediatric pts with advanced cancer (35 with hemoblastoses and 13 with solid tumors) have been transplanted from non-full-matched relatives without T-cell depletion in our department. The total number of transplantations was 55. The diagnoses were: AML: 12, ALL: 6, CML: 4, JMML: 7, NHL: 4, MDS: 2, Ews: 4, NB: 8, MLN: 1. HLA matching was: 3/6 — 65%, 4/5 and 5/6 — 35%. Recovery of donor hematopoiesis occurred in 43 pts (90%) at a mean of d+11. There was long-time disease stabilization in 2/6 children (JMML/MDS: 1, CML: 1) who were re-transplanted due to the rejection of the first graft. Acute GVHD grades II–IV occurred in 17 (35.5%) of pts (IV=0%); and chronic GVHD in 52% of pts.

At present 10/48 (21%) pts are alive in complete remission with a median follow-up of 26 months. The causes of mortality were: aGVHD: 3 (6%), cGVHD: 7 (15%), infection: 3 (6%), and disease progression: 25 (52%). Transplant-related mortality was 16% at d+100 and 24% at 12 months. Three and 5-yrs EFS of pts with hemoblastoses were 30% and 26% respectively. For pts with AML the transplantation results were most promising, with a 5-yr EFS rate of 42%. All the pts with solid tumors died, but there were 4 cases of prolonged disease stabilization (10, 16, 22, and 44 mos).

This method can be used with adequate aGVHD prophylaxis in children with advanced hemoblastoses. A “Graft-versus-tumor” effect in solid tumors is not sufficient for survival.

Keywords: allogeneic transplantation, partially mismatched, children, cancer