Document Detail


Non-T-cell-depleted HLA haploidentical stem cell transplantation in advanced hematologic malignancies based on the feto-maternal michrochimerism.
MedLine Citation:
PMID:  12480695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Feto-maternal microchimerism suggests that immunologic tolerance exists between mother and fetus. Based on this hypothesis, we performed haploidentical stem cell transplantation (SCT) without T-cell depletion (TCD) in 5 patients with advanced hematologic malignancies. HLA incompatibilities for graft-versus-host disease (GVHD) direction included 3-loci mismatches in 4 patients, and 2-loci mismatches in one patient. Recipient chimeric cells were detected in all patients. The prophylaxis against GVHD was tacrolimus with minidose methotrexate. Engraftment was obtained in all patients. An acute GVHD of less than or equal to grade 2 developed in all patients except one who developed tacrolimus encephalopathy. Two patients died, 1 from fungal pneumonia and 1 from disease progression. The other 3 patients survived, with one patient in complete remission. These observations suggest that haploidentical SCT based on the feto-maternal microchimerism without TCD is possible.
Authors:
Chihiro Shimazaki; Naoya Ochiai; Ryo Uchida; Akira Okano; Shin-ichi Fuchida; Eishi Ashihara; Tohru Inaba; Naohisa Fujita; Etsuko Maruya; Masao Nakagawa
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Publication Detail:
Type:  Journal Article     Date:  2002-12-12
Journal Detail:
Title:  Blood     Volume:  101     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-03     Completed Date:  2003-06-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3334-6     Citation Subset:  AIM; IM    
Affiliation:
Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan. simazaki@koto.kpu-m.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Chimera / immunology*
Female
Graft Survival
Graft vs Host Disease / immunology
HLA Antigens / genetics*
Haplotypes / genetics
Histocompatibility
Humans
Immune Tolerance / immunology*
Infection
Leukemia / genetics,  immunology,  therapy*
Male
Maternal-Fetal Exchange*
Mothers
Peripheral Blood Stem Cell Transplantation*
Pregnancy
Remission Induction
Siblings
Transplantation, Homologous / immunology*
Treatment Outcome
Chemical
Reg. No./Substance:
0/HLA Antigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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