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Prepublished online as a Blood First Edition Paper on December 12, 2002; DOI 10.1182/blood-2002-09-2883.
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Blood, 15 April 2003, Vol. 101, No. 8, pp. 3334-3336
TRANSPLANTATION
Brief report
Non-T-cell-depleted HLA haploidentical stem cell
transplantation in advanced hematologic malignancies based on the
feto-maternal michrochimerism
Chihiro Shimazaki,
Naoya Ochiai,
Ryo Uchida,
Akira Okano,
Shin-ichi Fuchida,
Eishi Ashihara,
Tohru Inaba,
Naohisa Fujita,
Etsuko Maruya, and
Masao Nakagawa
From the Second Department of Medicine, Kyoto
Prefectural University of Medicine, Japan, and the HLA
Laboratory, Kyoto, Japan.
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.

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