ANALYSIS OF 13 PATIENTS UNDERGOING T CELL-REPLETE HEMATOPOIETIC STEM CELL TRANSPLANTATION FROM HLA HAPLOIDENTICAL FAMILY MEMBERS MISMATCHED FOR NIMAS (NONINHERITED MATERNAL ANTIGENS) AT THE NATIONAL HOSPITAL ORGANIZATION NAGOYA MEDICAL CENTER

• Published in: Japanese Journal of Transfusion and Cell Therapy Vol. 53; no. 6; pp. 591 - 597
• Main Authors: Hamaguchi, Motohiro, Kato, Chiaki, Yokozawa, Toshiya, Terasawa, Teruhiko, Suzuki, Nobuaki, Aoki, Etsuko, Ohashi, Haruhiko, Nagai, Hirokazu
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Transfusion Medicine and Cell Therapy 10.12.2007
• Subjects: HLA-haploidentical; NIMA; stem cell transplantation
• ISSN: 1881-3011; 1883-0625
• DOI: 10.3925/jjtc.53.591

Based on the hypothesis that long-term fetomaternal microchimerism is associated with acquired immunologic hyporesponsiveness to noninherited maternal antigens (NIMAs) or inherited paternal antigens (IPAs), we examined the outcomes of 13 patients with hematologic malignancies who underwent HLA-incompatible stem cell transplantation from a microchimeric NIMA-mismatched donor. Eleven of the 13 patients had sustained hematopoietic recovery with short-term methtrexate and tacrolimus for graft-versus-host disease (GVHD) prophylaxis. Grade II acute GVHD occurred in 3 (27%) of 11 evaluable patients, while extensive chronic GVHD developed in 4 (36%) of 11 patients. Five (38%) patients are alive, all of whom are disease-free with a median follow-up of 55 (range, 6 to 72) months. These results indicate that T cell-replete SCT from an HLA-haploidentical NIMA-mismatched donor can offer durable remission with an acceptable risk of GVHD in selected patients with hematological malignancies who lack immediate access to a conventional stem cell source.