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Haploidentical ‘megadose’ CD34+ cell transplants for patients with acute leukemia

Leukemia volume 16, pages 404–405 (2002)Cite this article

The two workshops on Haploidentical Stem Cell Transplantation were held in Italy and in the USA to communicate the achievements to date in this field. In the past decade, the histoincompatibility barrier, which was responsible for a high incidence of rejection in extensively T cell-depleted transplants, has successfully been overcome. There is no doubt that the turning point in the history of the T cell-depleted mismatched transplant was the infusion of a megadose of stem cells, a principle which had been amply demonstrated in animal models.

To date, the results obtained show that remarkable progress has been made in several areas. Full donor-type engraftment is successful and sustained in over 90% of recipients, when megadoses of highly purified CD34+ cells are given after highly immuno- and myelo-ablative conditioning regimens containing total body irradiation plus thiotepa, fludarabine and anti-thymocyte globulin (ATG) or based on chemotherapy alone (mainly in children). Graft-versus-host disease is almost fully prevented when using CD34+ cell selection devices. Following such procedures, the graft is extensively depleted of T cells, so that the mean T cell content does not exceed 1–2 × 104 cells/kg body weight.

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Acknowledgements

Prof Y Reisner is the incumbent of the Henry Drake Professorial Chair at the Weizmann Institute of Science. He was supported in part by the Rozansky Foundation as a Visiting Professor at the College of Physicians and Surgeons of Columbia University in New York and by The Gabrielle Rich Leukemia Research Foundation.

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  1. Department of Clinical and Experimental Medicine, Section of Hematology, University of Perugia, Perugia, Italy

    MF Martelli

  2. Department of Immunology, The Weizmann Institute of Science, Rehovot, Israel

    Y Reisner

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  1. MF Martelli
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Martelli, M., Reisner, Y. Haploidentical ‘megadose’ CD34+ cell transplants for patients with acute leukemia. Leukemia 16, 404–405 (2002). https://doi.org/10.1038/sj.leu.2402382

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