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Blood, 7 May 2009, Vol. 113, No. 19, pp. 4771-4779. Prepublished online as a Blood First Edition Paper on February 11, 2009; DOI 10.1182/blood-2008-10-183723. This Article Full Text Full Text (PDF) Supplemental Figures All Versions of this Article: blood-2008-10-183723v1 113/19/4771    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Dodero, A. Articles by Corradini, P. Search for Related Content PubMed PubMed Citation Articles by Dodero, A. Articles by Corradini, P. Related Collections Transplantation Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Haploidentical stem cell transplantation after a reduced-intensity conditioning regimen for the treatment of advanced hematologic malignancies: posttransplantation CD8-depleted donor lymphocyte infusions contribute to improve T-cell recovery Anna Dodero1,*, Cristiana Carniti1,*, Anna Raganato1, Antonio Vendramin1, Lucia Farina1, Francesco Spina1, Carmelo Carlo-Stella2,3, Simona Di Terlizzi1, Marco Milanesi2, Paolo Longoni2, Lorenza Gandola4, Claudia Lombardo5, and Paolo Corradini1,6 1 Division of Hematology and Bone Marrow Transplantation and 2 Cristina Gandini Division of Medical Oncology, Istituto Nazionale dei Tumori, Milan; 3 Chair of Oncology, University of Milan, Milan; 4 Radiotherapy Department and 5 HLA Typing Laboratory, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Nazionale dei Tumori, Milan; and 6 Chair of Hematology, University of Milan, Milan, Italy Haploidentical hematopoietic stem cell transplantation provides an option for patients with advanced hematologic malignancies lacking a compatible donor. In this prospective phase 1/2 trial, we evaluated the role of reduced-intensity conditioning (RIC) followed by early add-backs of CD8-depleted donor lymphocyte infusions (DLIs). The RIC regimen consisted of thiotepa, fludarabine, cyclophosphamide, and 2 Gy total body irradiation. Twenty-eight patients with advanced lymphoproliferative diseases (n = 24) or acute myeloid leukemia (n = 4) were enrolled. Ex vivo and in vivo T-cell depletion was carried out by CD34+ cell selection and alemtuzumab treatment. The 2-year cumulative incidence of nonrelapse mortality was 26% and the 2-year overall survival (OS) was 44%, with a better outcome for patients with chemosensitive disease (OS, 75%). Overall, 54 CD8-depleted DLIs were administered to 23 patients (82%) at 3 different dose levels without loss of engraftment or acute toxicities. Overall, 6 of 23 patients (26%) developed grade II-IV graft-versus-host disease, mainly at dose level 2. In conclusion, our RIC regimen allowed a stable engraftment with a rather low nonrelapse mortality in poor-risk patients; OS is encouraging with some long-term remissions in lymphoid malignancies. CD8-depleted DLIs are feasible and promote the immune reconstitution. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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