Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2018; 17: 51-58
Использование профилактики острой реакции «трансплантат против хозяина» на основе посттрансплантационного циклофосфамида у пациентов с незлокачественными заболеваниями системы кроветворения и наследственными синдромами, имеющими показания к выполнению аллогенной трансплантации костного мозга
https://doi.org/10.24287/1726-1708-2018-17-2-51-58Аннотация
Список литературы
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9. Moiseev I.S., Pirogova O.V., Alyanski A.L., Babenko E.V., Gindina T.L., Darskaya E.I., Slesarchuk O.A., et al. Graft-versus-Host Disease Prophylaxis in Unrelated Peripheral Blood Stem Cell Transplantation with Post-Transplantation Cyclophosphamide, Tacrolimus, and Mycophenolate Mofetil. Biol Blood Marrow Transplant 2016; 22 (6): 1037-42.
10. Rastogi N., Katewa S.,Thakkar D., Kohli S., Nivargi S.,Yadav S.P. Reduced-toxicity alternate-donor stem cell transplantation with posttransplant cyclophosphamide for primary immunodeficiency disorders. Pediatr Blood Cancer 2017; 00: e26783.
11. Thakkar D., Katewa S., Rastogi N., Kohli S., Nivargi S., Yadav S.P. Successful Reduced Intensity Conditioning Alternate Donor Stem Cell Transplant for Wiskott-Aldrich Syndrome. J Pediatr Hematol Oncol 2017; 39 (8): e493-e496.
12. Wiebking V., Hütker S., Schmid I., Immler S., Feuchtinger T., Albert M.H. Reduced toxicity, myeloablative HLA-haploidentical hematopoietic stem cell transplantation with post-transplantation cyclophosphamide for sickle cell disease. Ann Hematol 2017; 96 (8): 1373-7.
13. Jaiswal S.R., Chakrabarti A., Chatte-rjee S., Ray K., Chakrabarti S. Haploidentical transplantation in children with unmanipulated peripheral blood stem cell graft: The need to look beyond post-transplantation cyclophosphamide in younger children. Pediatr Transplant 2016 Aug; 20 (5): 675-82.
Pediatric Hematology/Oncology and Immunopathology. 2018; 17: 51-58
Acute GvHD prophylaxis with posttransplant cyclophosphamide after hematopoietic stem cell transplantation (HSCT) for non-malignant disorders
https://doi.org/10.24287/1726-1708-2018-17-2-51-58Abstract
Transplantation of allogeneic hematopoietic stem cells (allo-HSCT) is an effective treatment method for non-malignant diseases and inherited disorders. Development of acute GVHD is a negative factor for outcomes. Using «novel» strategies for drug prophylaxis, such as posttransplant cyclophosphamide (PtCy) allows to decrease the GVHD risk. The aim of this study: to assess efficiency of PtCy as a prophylaxis aGVHDin the patients with non-malignant diseases of hematopoiesis and inherited syndromes. 97 patients with non-malignant blood disorders and metabolic diseases received 118 underwent allo-HSCT at the R. Gorbacheva Memorial Institute of Children Oncology and Transplantation. The aGVHD prophylaxis in 89 cases was performed by a standard schedule (with calcineurin inhibitors). 29 patients were treated according to PtCy regimen, at a dose of 50 mg/kg at days +3, +4. Cumulative incidence (CI) of aGVHD comprised 32%. Patients treated with PtCy exhibited lower rates of this condition compared to the group with standard prophylaxis schedule (26 vs 47%, р = 0.05). CI of skin aGVHD was also less common in the PtCy group (23 vs 45%, р = 0.046); gastrointestinal aGVHD was observed at equal rates in the both groups. Stem cell engraftment after nonmyeloablative conditioning in HSCT patients with subsequent PtCy administration proved to be sufficiently weaker compared to other patients (86 vs 50%, р = 0.004). Conclusions: aGVHD prophylaxis based on posttransplant PtCy is an efficient method which may decrease aGVHD risk. However, one should take into account a higher non-engraftment rate as a potential hazard of HSCT when using non-myeloablative conditioning regimens and PtCy-based GVHD prophylaxis.
References
1. Passweg J.R., Baldomero H., Bader P.,European Society for Blood and Marrow Transplantation (EBMT). Hematopoietic SCT in Europe 2013: recent trends in the use of alternative donors showing more haploidentical donors but fewer cord blood transplants. BoneMarrowTransplant 2015; 50 (4): 476-82.
2. Afanas'ev B.V., Zubarovskaya L.S., Moiseev I.S. Allogennaya transplantatsiya gemopoeticheskikh stvolovykh kletok u detei: nastoyashchee, problemy, perspektivy. Rossiiskii zhurnal detskoi gematologii i onkologii 2015; 2 (2): 28-42.
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7. Owens A.H., Santos G.W. The effect of cytotoxic drugs on graft-versus-host disease in mice. Transplantation 1971; 4 (11): 378-82.
8. Moiseev I.S., Pirogova O.V., Babenko E.V., Gindina T.L., Darskaya E.I., Morozova E.V., Bondarenko S.N., Afanasyev B.V. Single-agent post-transplantation cyclophosphamide versus calcineurin-based graft-versus-host disease prophylaxis in matched related bone marrow transplantation. Cellular Therapy and Transplantation 2017; 6 (4): 52-9.
9. Moiseev I.S., Pirogova O.V., Alyanski A.L., Babenko E.V., Gindina T.L., Darskaya E.I., Slesarchuk O.A., et al. Graft-versus-Host Disease Prophylaxis in Unrelated Peripheral Blood Stem Cell Transplantation with Post-Transplantation Cyclophosphamide, Tacrolimus, and Mycophenolate Mofetil. Biol Blood Marrow Transplant 2016; 22 (6): 1037-42.
10. Rastogi N., Katewa S.,Thakkar D., Kohli S., Nivargi S.,Yadav S.P. Reduced-toxicity alternate-donor stem cell transplantation with posttransplant cyclophosphamide for primary immunodeficiency disorders. Pediatr Blood Cancer 2017; 00: e26783.
11. Thakkar D., Katewa S., Rastogi N., Kohli S., Nivargi S., Yadav S.P. Successful Reduced Intensity Conditioning Alternate Donor Stem Cell Transplant for Wiskott-Aldrich Syndrome. J Pediatr Hematol Oncol 2017; 39 (8): e493-e496.
12. Wiebking V., Hütker S., Schmid I., Immler S., Feuchtinger T., Albert M.H. Reduced toxicity, myeloablative HLA-haploidentical hematopoietic stem cell transplantation with post-transplantation cyclophosphamide for sickle cell disease. Ann Hematol 2017; 96 (8): 1373-7.
13. Jaiswal S.R., Chakrabarti A., Chatte-rjee S., Ray K., Chakrabarti S. Haploidentical transplantation in children with unmanipulated peripheral blood stem cell graft: The need to look beyond post-transplantation cyclophosphamide in younger children. Pediatr Transplant 2016 Aug; 20 (5): 675-82.
