1. Haploidentical Stem Cell Transplantation With TCR αβ + /CD19 + Depletion in Children With Nonmalignant Hematologic Disorders: Outcomes From a Referral Center in Peru.
- Author
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Rodríguez-Torres JC, Pando-Caciano A, Mamaní-Cajachagua PE, and Murillo-Vizcarra SA
- Subjects
- Humans, Child, Adolescent, Child, Preschool, Peru, Male, Female, Infant, Receptors, Antigen, T-Cell, alpha-beta, Treatment Outcome, Lymphocyte Depletion, Retrospective Studies, Hematopoietic Stem Cell Transplantation adverse effects, Antigens, CD19, Hematologic Diseases therapy, Hematologic Diseases surgery, Transplantation, Haploidentical, Graft vs Host Disease immunology
- Abstract
Background: Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with TCR αβ
+ /CD19+ cell depletion is a promising therapeutic alternative for children with nonmalignant hematologic disorders, especially in low-income countries where finding a compatible donor is challenging. The use of this transplantation approach for nonmalignant hematologic disorders has not been previously described in the Peruvian pediatric population., Methods: We present the outcomes of children under 19 with nonmalignant hematologic disorders who underwent haplo-HSCT with TCR αβ+ /CD19+ cell depletion between 2018-2022 at a referral center in Lima, Peru. Survival probabilities and cumulative incidence functions were calculated using the Kaplan-Meier method., Results: A total of 17 children aged between 1 to 18.6 years (median = 9.7 years) were included. The follow-up period ranged from 10 days to 66.20 months, with a median of 4.34 months. The probability of overall survival, event-free survival, and failure-free survival was 33.70%, 31.40%, and 68.8%, respectively. The incidence rate of graft failure was 49.80%, while the mortality rate not associated with graft failure was 18.8%. The incidence rate of acute graft-versus-host disease (GvHD) was 25.60%, and the incidence rate of viral infections was 59.40%., Conclusions: The high incidence rates of graft failure and viral infections suggest that these factors may negatively impact the survival of children with nonmalignant hematologic disorders who undergo haplo-HSCT with TCR αβ+/CD19+ cell depletion. Therefore, optimizing the current conditioning regimens and ensuring timely access to first, second, and third-line antivirals is crucial to improve the survival of these patients., Competing Interests: Declaration of competing interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)- Published
- 2024
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