T Cell-Depleted Peripheral Blood versus Unmanipulated Bone Marrow in Matched Sibling Transplantation for Aplastic Anemia
Copyright © 2023 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved..
Bone marrow (BM) is the recommended stem cell source for hematopoietic stem cell transplantation (HSCT) from matched sibling donors (MSDs) in patients with severe aplastic anemia (SAA) for its superior survival and graft-versus-host disease (GVHD) outcomes compared to recipients of unmanipulated peripheral blood (PB) HSCT. Nevertheless, no studies comparing BM with ex vivo T cell-depleted (TCD) PB have been reported to date. The aim of the present study was to compare the transplantation outcomes of MSD HSCT recipients with SAA using PB (with partial ex vivo TCD targeted cell dose grafts) with those of MSD HSCT recipients with SAA using unmanipulated BM. We performed a matched-pair analysis of MSD-HSCT using TCD PB in a single institution with unmanipulated BM MSD-HSCT in the United States between 2013 and 2019 reported to the Center for International Blood and Marrow Transplant Research. We compared 23 recipients of TCD PB HSCT for SAA (cases) and 69 recipients of unmanipulated BM grafts (controls) matched for age, Karnofsky Performance Status, Hematopoietic Cell Transplantation-Specific Comorbidity Index, time from diagnosis to transplantation, and recipient cytomegalovirus serostatus. We found significantly faster neutrophil and platelet recovery in the TCD PB cohort (P < .001 and P = .03, respectively), as well as a lower incidence of grade II-IV acute GVHD (0% versus 17%; P = .05) and similar overall survival (96% versus 97% at 3 years; P = .8). Our study shows that TCD PB can be considered a safe source for MSD-HSCT in patients with SAA, with potential advantages in engraftment and GVHD that could challenge the standard with BM. These findings provide a basis for future research in a prospective controlled clinical trial.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Transplantation and cellular therapy - 29(2023), 5 vom: 01. Mai, Seite 322.e1-322.e5 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chorão, Pedro [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 10.05.2023 Date Revised 10.05.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jtct.2023.01.016 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Bone marrow (BM) is the recommended stem cell source for hematopoietic stem cell transplantation (HSCT) from matched sibling donors (MSDs) in patients with severe aplastic anemia (SAA) for its superior survival and graft-versus-host disease (GVHD) outcomes compared to recipients of unmanipulated peripheral blood (PB) HSCT. Nevertheless, no studies comparing BM with ex vivo T cell-depleted (TCD) PB have been reported to date. The aim of the present study was to compare the transplantation outcomes of MSD HSCT recipients with SAA using PB (with partial ex vivo TCD targeted cell dose grafts) with those of MSD HSCT recipients with SAA using unmanipulated BM. We performed a matched-pair analysis of MSD-HSCT using TCD PB in a single institution with unmanipulated BM MSD-HSCT in the United States between 2013 and 2019 reported to the Center for International Blood and Marrow Transplant Research. We compared 23 recipients of TCD PB HSCT for SAA (cases) and 69 recipients of unmanipulated BM grafts (controls) matched for age, Karnofsky Performance Status, Hematopoietic Cell Transplantation-Specific Comorbidity Index, time from diagnosis to transplantation, and recipient cytomegalovirus serostatus. We found significantly faster neutrophil and platelet recovery in the TCD PB cohort (P < .001 and P = .03, respectively), as well as a lower incidence of grade II-IV acute GVHD (0% versus 17%; P = .05) and similar overall survival (96% versus 97% at 3 years; P = .8). Our study shows that TCD PB can be considered a safe source for MSD-HSCT in patients with SAA, with potential advantages in engraftment and GVHD that could challenge the standard with BM. These findings provide a basis for future research in a prospective controlled clinical trial | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a Allogeneic stem cell transplantation | |
| 650 | 4 | |a Ex vivo T cell depletion | |
| 650 | 4 | |a Matched sibling donor | |
| 650 | 4 | |a Severe aplastic anemia | |
| 700 | 1 | |a Montoro, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Balaguer-Roselló, Aitana |e verfasserin |4 aut | |
| 700 | 1 | |a Guerreiro, Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Villalba, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Facal, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Solves, Pilar |e verfasserin |4 aut | |
| 700 | 1 | |a Gómez-Segui, Inés |e verfasserin |4 aut | |
| 700 | 1 | |a Pasquini, Marcelo C |e verfasserin |4 aut | |
| 700 | 1 | |a Granados, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Bataller, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Louro, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a de la Rubia, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Sanz, Miguel A |e verfasserin |4 aut | |
| 700 | 1 | |a Sanz, Jaime |e verfasserin |4 aut | |
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