Korean J Hematol.  2003 Nov;38(4):221-227.

Haplotype Mismatch Transplantation using High-dose CD34+ Cells with Stratified New Conditioning Regimens in Patients with Acute Myeloid Leukemia

• Kim HJ
• Min WS
• Choi SM
• Lee DG
• Park YH
• Lee JW
• Park JW
• Kim CC

Abstract

BACKGROUND
Although haploidentical transplantation has become a clinical reality for acute myeloid leukemia (AML) patients lacking a HLA compatible donor due to several encouraging reports, it is still considered as one of an experimental treatment modalities.
METHODS
Eleven patients received stem cell transplantation from family donors having mismatched HLA haplotypes. For patients who were planned for 2 or 3 major antigens mismatch transplantation, their conditioning regimens included total-body irradiation (TBI), intravenous busulfan, antithymocyte globulin, and fludarabine in 6 patients and non-TBI containing regimen in 2 patients. For 3 patients with 1 major antigen mismatch sibling donor, we used 3 different regimens according to the patients' condition. The median number of infused CD34+ cells were 15.4x10(6)/kg (range, 8~21.2).
RESULTS
Ten patients who were followed up for at least median 4 months (range, 17 days-15 months) showed stable engraftment. Patients who received haploidentical transplantation in first or second complete remission (CR), all showed continuous CR within our study period and showed no acute graft-versus-host disease or transplant-related mortality during 100 day posttransplant. Three of 5 patients who were in relapse or refractory state finally died in relapse. Two of 3 patients who received the full haplotype mismatch transplantation in CR died after 4 months posttransplant due to critical infections associated with delayed immune recovery.
CONCLUSION
Our experience suggests that haploidentical transplantation is at least, in part, feasible or desperate treatment for patients with high-risk AML in CR. We need further stable plan to enhance the immune recovery for these patients as soon as possible.

Keyword

Haplotype mismatch transplantation; CD34+ cells; Acute myeloid leukemia

MeSH Terms

Antilymphocyte Serum
Busulfan
Graft vs Host Disease
Haplotypes*
Humans
Leukemia, Myeloid, Acute*
Mortality
Recurrence
Siblings
Stem Cell Transplantation
Tissue Donors
Antilymphocyte Serum
Busulfan