HLA-haploidentical nonmyeloablative stem cell transplantation: induction to tolerance without passing through mixed chimaerism

Clin Lab Haematol. 2005 Apr;27(2):139-41. doi: 10.1111/j.1365-2257.2005.00675.x.

Abstract

There are few reports of unmanipulated HLA-haploidentical nonmyeloablative stem cell transplantation (NST) using only pharmacological acute graft-vs.-host disease (GVHD) prophylaxis. We present here a successful case of unmanipulated HLA-haploidentical NST for mediastinal large B cell lymphoma that was resistant to autologous peripheral blood stem cell transplantation (PBSCT). The conditioning regimen consisted of fludarabine, busulfan and rabbit anti-T-lymphocyte globulin (ATG) in addition to rituximab. GVHD prophylaxis was performed using tacrolimus and methylprednisolone 1 mg/kg. The patient had rapid engraftment, with 100% donor chimaerism in the lineages of both T cells and granulocytes on day +12, but developed no GVHD clinically. The patient is still in complete remission past day +1020, with no sign of chronic GVHD without receiving immunosuppressive agents. HLA-haploidentical NST may be performed without utilizing mixed chimaerism.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Graft Survival
  • Graft vs Host Disease / prevention & control
  • Haplotypes
  • Hematopoietic Stem Cell Transplantation / methods*
  • Histocompatibility Testing*
  • Humans
  • Immunosuppression Therapy / methods
  • Lymphoma, B-Cell / therapy
  • Mediastinal Neoplasms / therapy
  • Transplantation Chimera
  • Transplantation Conditioning / methods