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. 2021 Nov;41(8):1754-1761.
doi: 10.1007/s10875-021-01113-4. Epub 2021 Aug 6.

Haploidentical Hematopoietic Cell Transplantation Using Post-transplant Cyclophosphamide for Children with Non-malignant Diseases

Hasan Hashem  1 , Rula Najjar  2 , Mayada Abu-Shanap  3 , Eman Khattab  3 , Rawad Rihani  3 , Abdelghani Tbakhi  4 , Iyad Sultan  3
Affiliations

Haploidentical Hematopoietic Cell Transplantation Using Post-transplant Cyclophosphamide for Children with Non-malignant Diseases

Hasan Hashem et al. J Clin Immunol. 2021 Nov.

Abstract

Haploidentical hematopoietic cell transplantation (HCT) is a valuable curative option for children with non-malignant diseases. Haploidentical HCT using post-transplant cyclophosphamide (PTCy) is a readily available option in the absence of an HLA-matched donor. We conducted a retrospective single-center study on the outcome of haploidentical HCT in children with non-malignant diseases. We gathered data from 44 patients underwent HCT in the period 2015 to 2020. The indications for HCT were bone marrow failure, primary immunodeficiency, metabolic disorders, and hemoglobinopathy. Median age at HCT was 4 years (range 0.7-20). The conditioning regimens were myeloablative (n = 17) or reduced intensity (n = 27). After a median follow-up of 20 months (range 4-71), 2-year overall survival was 89% and 2-year GvHD-free relapse-free survival (GRFS) was 66%. Incidence of primary graft failure was 13.6%. Cumulative incidence of grade II-IV acute and moderate/severe chronic GvHD were 20% and 6.4%, respectively. Younger age at HCT (< 4 years) and primary immunodeficiency were significantly associated with better GRFS (p < 0.05). In conclusion, haploidentical HCT using PTCy is feasible and curative in children with non-malignant diseases lacking an HLA-matched donor. Early diagnosis and referral in addition to timely treatment can further improve outcomes.

Keywords: HSCT; Haploidentical; Hematopoietic cell transplantation; Non-malignant diseases; Post-transplant cyclophosphamide; Primary immunodeficiency.

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References

    1. Steward CG. Hematopoietic stem cell transplantation for osteopetrosis. Pediatr Clin N Am. 2010;57(1):171–80. https://doi.org/10.1016/j.pcl.2009.11.006 . - DOI
    1. Shenoy S, Boelens JJ. Advances in unrelated and alternative donor hematopoietic cell transplantation for nonmalignant disorders. Curr Opin Pediatr. 2015;27(1):9–17. https://doi.org/10.1097/MOP.0000000000000179 . - DOI - PubMed - PMC
    1. Bertaina A, Pitisci A, Sinibaldi M, Algeri M. T Cell-depleted and T cell-replete HLA-haploidentical stem cell transplantation for non-malignant disorders. Curr Hematol Malig Rep. 2017;12(1):68–78. https://doi.org/10.1007/s11899-017-0364-3 . - DOI - PubMed
    1. Alter BP. Inherited bone marrow failure syndromes: considerations pre- and posttransplant. Hematology. 2017;2017(1):88–95. https://doi.org/10.1182/asheducation-2017.1.88 . - DOI - PubMed - PMC
    1. Gennery AR, Albert MH, Slatter MA, Lankester A. Hematopoietic stem cell transplantation for primary immunodeficiencies. Front Pediatr. 2019;7(October):7–10. https://doi.org/10.3389/fped.2019.00445 . - DOI

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