Sufficient Immunosuppression with Thymoglobulin Is Essential for a Successful Haplo-Myeloid Bridge in Haploidentical-Cord Blood Transplantation.

摘要: Abstract In haploidentical (haplo)-cord blood (CB) transplantations, early haplo donor engraftment serves as a myeloid bridge to sustainable CB and is associated with neutrophil recovery. The conditioning regimens published for haplo-cord protocols usually contain serotherapy, such rabbit antithymocyte globulin (ATG) (Thymoglobulin, Genzyme, Cambridge, MA). However, reducing or omitting serotherapy an important strategy improve immune reconstitution after transplantation. need in successful transplantation, defined having haplo-derived engraftment, has not been investigated before. Two consecutive cohorts of patients underwent transplantation haplo-CB. first group haplo-CB active infection and/or underlying condition expected difficult without conventional available. They received single unit (s) cells (CD34+ selected, 5 × 106 CD34+/kg). second cohort included poor-risk malignancies, eligible other treatment protocols. sCB (CD19/αβTCR-depleted; Retrospectively both cohorts, ATG (Thymoglobulin) levels were measured post–hematopoietic cell area under the curve (AUC) was calculated. influence exposure haplo-myeloid (early before no secondary neutropenia) transplantation-related mortality (TRM) analyzed primary endpoints. Twenty (16 4 cohort). 58% evaluable patients, there which low post-transplantation appeared be predictor (P