The outcomes of an historic comparison of 117 consecutive, high-risk, acute leukemia patients undergoing hematopoietic stem cell transplantation (HSCT) from HLA-mismatched/haploidentical donors (HID, n = 81) or HLA-identical sibling donors (ISD, n = 36) without the use of in vitro T cell depletion (TCD), between the period of January 2005 and April 2009 were compared. Full engraftment was achieved in 98% of patients in the HID group and 97% in the ISD group. The cumulative incidences of grades II-IV acute graft-versus-host disease (aGVHD) in the HID and ISD cohorts were 49% and 24%, respectively (P = .014) with a relative risk (RR) of 2.99 (1.25-7.21) (P = .014). The incidence of chronic GVHD (cGVHD) did not differ significantly between the 2 cohorts. The 2-year cumulative incidence of relapse was significantly lower in HID (26%) than in ISD patients (49%) (P = .008). The 2-year cumulative incidence of nonrelapse mortality (NRM) was comparable in recipients of HID (34%) and ISD grafts (38%) (P = .85). The 3-year probability of overall survival (OS) was higher in HID patients (42%) than in ISD (20%) (P = .048) patients. Our comparisons suggest that HID transplants can achieve a stronger graft-versus-leukemia (GVL) effect than ISD for high-risk acute leukemia patients.
"A single-center study reported that unmanipulated myeloablative HSCT using the GIAC protocol has similar LFS/grade, III-IVaGVHD/extensive, chronic GVHD compared with HLA-matched sibling transplantation or matched unrelated donor transplantation [19,21]. The GIAC protocol also demonstrated improved GVL effects . Also, modified haploidentical nonmyeloablative transplantation without T cell depletion and haploidentical PBSCT have been successfully launched as routine procedures in other centers in China [16,23]. "
[Show abstract][Hide abstract] ABSTRACT: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and sometimes the only curative therapy for patients with certain hematological diseases. Allo-HSCT has been practiced in China for approximately 30 years, and great improvements have been made within the past decade, particularly in fields such as the haploidentical HSCT system, strategies to overcome relapse and GVHD, and modified HSCT for elderly patients. This review will describe the current situation and provide a prospective of these unique aspects of Allo-HSCT in China.
[Show abstract][Hide abstract] ABSTRACT: A pipelined ADC is presented in which the key component, the comparator, is designed using a latch structure which decreases the settling time and minimizes static power dissipation. Offset errors caused by device mismatch are cancelled using an autozeroing technique. The gain cell and subtractor is designed using a differential mode source follower to maximize the speed and minimize the power consumption and die area. The automatic gain calibration scheme is addressed. The circuit implementation enables operation at a 20 MHz sampling rate with only 25 mW average power dissipation. It achieves 10-bit resolution with the die area being less than 0.8 mm<sup>2</sup> in a 0.8 μm technology
Signals, Systems & Computers, 1997. Conference Record of the Thirty-First Asilomar Conference on; 12/1997
[Show abstract][Hide abstract] ABSTRACT: Haploidentical stem cell transplantation is an attractive form of transplantation because of the immediate donor availability, ease of stem cell procurement, and the possibility to further collect donor cells for cellular therapy. Historically, maintaining T cells in the graft has been associated with very high rates of graft-versus-host-disease (GVHD), whereas T cell-depleted haploidentical transplantation has been limited by a higher incidence of graft rejection and nonrelapse mortality related to infectious complications as a result of delayed immune reconstitution posttransplantation. Recent approaches have attempted to eliminate the alloreactive T cells to prevent GVHD posttransplantation. Administration of high-dose cyclophosphamide early posttransplantation in combination with tacrolimus and mycophenolate mofetil has produced engraftment and GVHD rates similar to HLA-matched sibling transplants, suggesting that the most important barriers against successful haploidentical transplantation can be overcome. Future directions should focus on optimizing conditioning regimens for different diseases and prevention of disease relapse posttransplantation.
Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 08/2011; 18(3):372-80. DOI:10.1016/j.bbmt.2011.08.001 · 3.40 Impact Factor
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