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T-Cell Replete Myeloablative Haploidentical Bone Marrow Transplantation Is an Effective Option for Pediatric and Young Adult Patients With High-Risk Hematologic Malignancies.
Front Pediatr. 2020; 8:282.FP

Abstract

Twenty-one pediatric and young adult patients (1.1-24.7 years) with hematologic malignancies underwent myeloablative T-cell replete haploidentical bone marrow transplant (haplo-BMT) between October 2015 to December 2019. Fifty-seven percent of the patients were ethnic or racial minorities. Thirteen patients had B-cell precursor acute lymphoblastic leukemia (B-ALL) with 10 receiving 1,200 cGy fractionated total body irradiation with fludarabine while the remaining 11 patients had targeted dose-busulfan, fludarabine, melphalan conditioning. Graft-vs.-host disease (GvHD) prophylaxis consisted of post-transplant cyclophosphamide (15 patients) or cyclophosphamide and bendamustine (six patients), with all patients receiving tacrolimus and mycophenolate mofetil. Twelve patients were in first or second remission at time of transplant with five in >2nd remission and four with measurable disease. Three patients had failed prior transplants and three CAR-T cell therapies. Only one patient developed primary graft failure but engrafted promptly after a second conditioned T-replete peripheral blood stem cell transplant from the same donor. An absolute neutrophil count of 0.5 × 109/L was achieved at a median time of 16 days post-BMT while platelet engraftment occurred at a median of 30 days. The cumulative incidence of grades III to IV acute GvHD and chronic GvHD was 15.2 and 18.1%, respectively. With a median follow-up of 25.1 months the relapse rate is 17.6% with an overall survival of 84.0% and a progression-free survival of 74.3%. The chronic graft-vs.-host-free relapse-free survival (CRFS) is 58.5% while acute and chronic graft-vs.-host-free relapse-free survival (GRFS) is 50.1%. Myeloablative conditioned T-replete haploidentical BMT is a viable alternative to matched unrelated transplantation for children and young adults with high-risk hematologic malignancies.

Authors+Show Affiliations

Department of Pediatrics, University of Arizona, Tucson, AZ, United States. Department of Immunobiology, University of Arizona, Tucson, AZ, United States. Department of Medicine, University of Arizona, Tucson, AZ, United States. Department of Pathology, University of Arizona, Tucson, AZ, United States. The University of Arizona Cancer Center, Tucson, AZ, United States. Banner University Medical Center, Tucson, AZ, United States. Banner Cardon Children's Medical Center, Mesa, AZ, United States.Department of Pediatrics, University of Arizona, Tucson, AZ, United States. Banner University Medical Center, Tucson, AZ, United States.Department of Pediatrics, University of Arizona, Tucson, AZ, United States. Banner University Medical Center, Tucson, AZ, United States.Department of Pediatrics, University of Arizona, Tucson, AZ, United States. Banner Cardon Children's Medical Center, Mesa, AZ, United States.The University of Arizona Cancer Center, Tucson, AZ, United States. Banner University Medical Center, Tucson, AZ, United States. Department of Radiation Oncology, University of Arizona, Tucson, AZ, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32582591

Citation

Katsanis, Emmanuel, et al. "T-Cell Replete Myeloablative Haploidentical Bone Marrow Transplantation Is an Effective Option for Pediatric and Young Adult Patients With High-Risk Hematologic Malignancies." Frontiers in Pediatrics, vol. 8, 2020, p. 282.
Katsanis E, Sapp LN, Reid SC, et al. T-Cell Replete Myeloablative Haploidentical Bone Marrow Transplantation Is an Effective Option for Pediatric and Young Adult Patients With High-Risk Hematologic Malignancies. Front Pediatr. 2020;8:282.
Katsanis, E., Sapp, L. N., Reid, S. C., Reddivalla, N., & Stea, B. (2020). T-Cell Replete Myeloablative Haploidentical Bone Marrow Transplantation Is an Effective Option for Pediatric and Young Adult Patients With High-Risk Hematologic Malignancies. Frontiers in Pediatrics, 8, 282. https://doi.org/10.3389/fped.2020.00282
Katsanis E, et al. T-Cell Replete Myeloablative Haploidentical Bone Marrow Transplantation Is an Effective Option for Pediatric and Young Adult Patients With High-Risk Hematologic Malignancies. Front Pediatr. 2020;8:282. PubMed PMID: 32582591.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - T-Cell Replete Myeloablative Haploidentical Bone Marrow Transplantation Is an Effective Option for Pediatric and Young Adult Patients With High-Risk Hematologic Malignancies. AU - Katsanis,Emmanuel, AU - Sapp,Lauren N, AU - Reid,Susie Cienfuegos, AU - Reddivalla,Naresh, AU - Stea,Baldassarre, Y1 - 2020/06/09/ PY - 2020/02/26/received PY - 2020/05/05/accepted PY - 2020/6/26/entrez PY - 2020/6/26/pubmed PY - 2020/6/26/medline KW - GvHD KW - T-replete KW - haploidentical BMT KW - myeloablative KW - pediatric SP - 282 EP - 282 JF - Frontiers in pediatrics JO - Front Pediatr VL - 8 N2 - Twenty-one pediatric and young adult patients (1.1-24.7 years) with hematologic malignancies underwent myeloablative T-cell replete haploidentical bone marrow transplant (haplo-BMT) between October 2015 to December 2019. Fifty-seven percent of the patients were ethnic or racial minorities. Thirteen patients had B-cell precursor acute lymphoblastic leukemia (B-ALL) with 10 receiving 1,200 cGy fractionated total body irradiation with fludarabine while the remaining 11 patients had targeted dose-busulfan, fludarabine, melphalan conditioning. Graft-vs.-host disease (GvHD) prophylaxis consisted of post-transplant cyclophosphamide (15 patients) or cyclophosphamide and bendamustine (six patients), with all patients receiving tacrolimus and mycophenolate mofetil. Twelve patients were in first or second remission at time of transplant with five in >2nd remission and four with measurable disease. Three patients had failed prior transplants and three CAR-T cell therapies. Only one patient developed primary graft failure but engrafted promptly after a second conditioned T-replete peripheral blood stem cell transplant from the same donor. An absolute neutrophil count of 0.5 × 109/L was achieved at a median time of 16 days post-BMT while platelet engraftment occurred at a median of 30 days. The cumulative incidence of grades III to IV acute GvHD and chronic GvHD was 15.2 and 18.1%, respectively. With a median follow-up of 25.1 months the relapse rate is 17.6% with an overall survival of 84.0% and a progression-free survival of 74.3%. The chronic graft-vs.-host-free relapse-free survival (CRFS) is 58.5% while acute and chronic graft-vs.-host-free relapse-free survival (GRFS) is 50.1%. Myeloablative conditioned T-replete haploidentical BMT is a viable alternative to matched unrelated transplantation for children and young adults with high-risk hematologic malignancies. SN - 2296-2360 UR - https://www.unboundmedicine.com/medline/citation/32582591/T-Cell_Replete_Myeloablative_Haploidentical_Bone_Marrow_Transplantation_Is_an_Effective_Option_for_Pediatric_and_Young_Adult_Patients_With_High-Risk_Hematologic_Malignancies L2 - https://doi.org/10.3389/fped.2020.00282 DB - PRIME DP - Unbound Medicine ER -
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