Haploidentical allogeneic hematopoietic transplant of hematopoietic parents in pediatrics in Uruguay

  • Gustavo Dufort Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico. Coordinador
  • Luis A. Castillo Centro Hospitalario Pereira Rossell. Centro Hemato-Oncológico Pediátrico. Director
  • Silvia Pisano Centro Hospitalario Pereira Rossell, Departamento de Hemoterapia y Medicina Transfusional.
  • Mariela Castiglioni Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • Carolina Pagés Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • Elizabeth Simón Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • Silvana Zuccolo Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • Andrea Incoronato Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • Rodrigo Barcelona Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • Magdalena Schelotto Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • Fabiana Morosini Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • María Ferrando Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico.
  • Clara Peña Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico. Nurse Jefe
  • Anaulina Silveira Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico. Analista de datos
  • Adriana Tiscornia Centro Hospitalario Pereira Rossell, Departamento de Hemoterapia y Medicina Transfusional.
  • Rossana Mezzano Centro Hospitalario Pereira Rossell, Departamento de Hemoterapia y Medicina Transfusional.
  • Felipe Lemos Centro Hospitalario Pereira Rossell, Departamento de Hemoterapia y Medicina Transfusional.
  • Luján Guerrero Centro Hospitalario Pereira Rossell, Departamento de Radioterapia.
  • Valentina Ferreira Centro Hospitalario Pereira Rossell, Departamento de Radioterapia.
  • Hugo Giordano Asociación Española, Laboratorio de Citometría de Flujo. Jefe
  • Beatriz Boggia Centro Hospitalario Pereira Rossell, Departamento de Hemoterapia y Medicina Transfusional. Jefe
  • Aldo Quarnetti Centro Hospitalario Pereira Rossell, Departamento de Radioterapia. Jefe
  • Agustín Dabezies Centro Hospitalario Pereira Rossell, Centro Hemato-Oncológico Pediátrico. Coordinador
Keywords: HOMOLOGOUS TRANSPLANTATION, HAPLOIDE, HEMATOPOIETIC STEM CELLS

Abstract

Introduction: allogenic hematopoietic stem cell transplantation (HSCT) is the only currently available curative treatment for a number of high-risk hematologic malignancies and for a range of inherited and acquired non-malignant diseases. Haploidentical (HI) HSCT is a valid option for patients who lack an HLA-identical brother.
Objective: to describe the results obtained with HI HSCT in pediatrics.
Method: in 2005 an HI HSCT program was started at the Pediatric Hemato-Oncological Department of the Centro Hospitalario Pereira Rossell, for patients who lack an HLA-matched related donor.
Results: Thirty two patients were transplanted, 24 of them with hematological malignancies and 8 with non-malignant diseases. Two strategies were used to prevent the Graft-Versus-Host-Disease (GVHD), in- vitro T-cell depletion (28 patients) and in-vivo depletion of aloreactives T-cells with high-dose post-transplantation cyclophosphamide (4 patients). Successful engraftment occurred in 27 patients (84%), with full-donor chimerism. Incidence of acute and chronic GVHD was 26.9% and 11.8% respectively. One year non-relapsed mortality was 21.9%. With a median follow-up of 32 months, the overall survival was 52.4%.
Conclusions: HI HSCT has proved to be a feasible option in our country for those patients without an HLA-identical donor. The results obtained are comparable to those obtained with other alternative donors and costs are more reasonable. Today, Uruguay is in a better position to offer a HSCT to patients who need it.

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Published
2014-03-31
How to Cite
1.
Dufort G, Castillo LA, Pisano S, Castiglioni M, Pagés C, Simón E, Zuccolo S, Incoronato A, Barcelona R, Schelotto M, Morosini F, Ferrando M, Peña C, Silveira A, Tiscornia A, Mezzano R, Lemos F, Guerrero L, Ferreira V, Giordano H, Boggia B, Quarnetti A, Dabezies A. Haploidentical allogeneic hematopoietic transplant of hematopoietic parents in pediatrics in Uruguay. Rev. Méd. Urug. [Internet]. 2014Mar.31 [cited 2024May21];30(1):17-9. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/256