Fiche publication
Date publication
novembre 2016
Journal
Bulletin du cancer
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RUBIO Marie Thérèse
Tous les auteurs :
Nguyen S, Chalandon Y, Lemarie C, Simon S, Masson D, Dhedin N, Suarez F, Renaud B, Charbonnier A, Yafour N, François S, Duléry R, Blaise D, Yakoub-Agha I, Rubio MT
Lien Pubmed
Résumé
Haploidentical hematopoietic stem cell transplantation (HSCT) is being increasingly used due to improvement of the transplantation procedures allowing a reduction of graft-versus-host-disease (GVHD) and of transplant-related mortality (TRM). Such improvements have been particularly observed after administration of T-replete HSCT graft associated to an in vivo T cell depletion by the administration of high-doses of cyclophosphamide (HD-Cy) after transplantation. Here, we have analyzed the results of haplo-identical T replete HSC transplants, in particular, when performed with post-transplant HD-Cy in order to provide recommendations for the clinical practice. Criteria of choice for a haploidentical donor by priority order are absence of donor-specific antibodies (DSA) and to prioritize: CMV seronegative recipient/donor couples, ABO matching in case of deserythrocytation, male donor for a male recipient, the youngest donor. There is no clear argument in favor of the use of bone marrow versus peripheral blood stem cells (PBSC) after non myeloablative conditioning regimen, while after ablative conditioning PBSC seem to be associated with higher risks of GVHD without obvious impact on survival. Results of haploidentical HSCT, confirmed by several groups, are interesting in lymphomas (in particular Hodgkin disease) and for acute leukemia. Outcomes of patients rely on age, disease status at transplant and conditioning intensity. At equivalent disease risk, results of haploidentical HSCT seem comparable to those of HLA matched HSCT, raising the question of the classification of such transplants as alternatives. In all cases, we recommend to include patients in prospective clinical trials.
Mots clés
ABO Blood-Group System, Age Factors, Bone Marrow Transplantation, standards, Donor Selection, standards, Graft vs Host Disease, immunology, Haploidy, Hematopoietic Stem Cell Transplantation, Histocompatibility, genetics, Histocompatibility Testing, Hodgkin Disease, therapy, Humans, Leukemia, therapy, Lymphoma, Non-Hodgkin, therapy, Sex Factors, Societies, Medical, T-Lymphocytes, immunology, Transplantation Conditioning, methods
Référence
Bull Cancer. 2016 Nov;103(11S):S229-S242
