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HLA-haploidentical peripheral blood stem cell transplantation following reduced-intensity conditioning with very low-dose antithymocyte globulin for relapsed/refractory acute leukemia in pediatric patients: a single-institution retrospective analysis

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Abstract

The prognosis of relapsed/refractory (R/R) pediatric acute leukemia is extremely poor. We retrospectively reviewed 20 consecutive pediatric patients with R/R acute leukemia who underwent a first HLA-haploidentical peripheral blood stem cell transplantation following reduced-intensity conditioning (haplo-RIC-PBSCT) with very low-dose antithymocyte globulin (ATG) between 2012 and 2019. Of these 20 patients, 7 patients had acute lymphoblastic leukemia, and 13 had acute myeloid leukemia. At the time of haplo-RIC-PBSCT, 15 patients had active disease. The median follow-up duration for survivors was 56 months (range 22–108 months). Graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus, short-term methotrexate, methylprednisolone, and ATG 1.25 mg/kg on day-2. The 2-year cumulative incidence of transplant-related mortality and relapse were 5.0% [95% confidence interval (CI) 0.7–30.5%)] and 57.8% (95% CI 37.4–79.6%), respectively. Among the 20 patients, 16 (80.0%) developed grade III–IV acute GVHD, and 2 developed severe chronic GVHD. The 2-year event-free survival and overall survival rates were 40.0% (95% CI 19.3–60.0%) and 50.0% (95% CI 27.1–69.2%), respectively. Although the sample size is small, the survival outcomes of the present study are encouraging.

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Authors and Affiliations

  1. Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital, 840 Murodo, Izumi, Osaka, 594-1101, Japan

    Kohei Higuchi, Akihisa Sawada, Osamu Kondo, Yosuke Okada, Hiroshi Tsujimoto, Aya Ioi, Azusa Mayumi, Mariko Shimizu, Maho Sato, Kimitoshi Goto, Shota Inoue, Masahiro Yasui & Masami Inoue

Authors
  1. Kohei Higuchi
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  2. Akihisa Sawada
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  3. Osamu Kondo
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  4. Yosuke Okada
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  5. Hiroshi Tsujimoto
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  6. Aya Ioi
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  7. Azusa Mayumi
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  8. Mariko Shimizu
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  9. Maho Sato
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  10. Kimitoshi Goto
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  11. Shota Inoue
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  12. Masahiro Yasui
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  13. Masami Inoue
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Contributions

KH designed and performed the research, analyzed the data, and wrote the manuscript. OK designed and performed the research and treated the patients. YO, HT, AI, AM, MS, MS, KG, SI, MY, and MS treated the patients. AS and MI supervised the research and manuscript.

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Correspondence to Kohei Higuchi.

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The authors declare no conflicts of interest.

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Higuchi, K., Sawada, A., Kondo, O. et al. HLA-haploidentical peripheral blood stem cell transplantation following reduced-intensity conditioning with very low-dose antithymocyte globulin for relapsed/refractory acute leukemia in pediatric patients: a single-institution retrospective analysis. Int J Hematol 115, 406–413 (2022). https://doi.org/10.1007/s12185-021-03270-z

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  • DOI: https://doi.org/10.1007/s12185-021-03270-z

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