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Influence of HLA-B Leader (-21M/T) Dimorphism With Bw4/Bw6 Epitopes on Graft Versus Host Disease After Allogenic Haematopoietic Stem Cell Transplantation in North Indians.
Int J Immunogenet
January 2025
Department of Clinical Haematology and Medical Oncology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
High degree of variability in human leukocyte antigens (HLAs) system restricts availability of histocompatible HLA-matched-related donors, thus increasing reliance on worldwide bone marrow registries network. Nevertheless, due to limited coverage/accessibility/affordability of some ethnicities in these registries, haploidentical haematopoietic stem cell transplantation (HSCT) emerged as an alternative option, though with allorecognition-mediated graft versus host disease (GvHD) (>40% cases). A dimorphism [-21 methionine (M) or threonine (T)] in HLA-B leader peptide (exon 1) which differentially influences its HLA-E binding, plausibly regulates natural killer cell functionality, affecting GvHD vulnerability and clinically in practice for donor selection.
View Article and Find Full Text PDFComparison of Outcomes of Haploidentical Peripheral Blood Stem Cell Transplantation with Post-Transplant Cyclophosphamide in Older Versus Younger Patients.
Cancers (Basel)
January 2025
Department of Bone Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA.
Background: Previous studies have shown that allogeneic peripheral blood stem cell transplantation (PBSCT) from an HLA haploidentical (haplo) donor followed by graft-versus-host disease (GVHD) prophylaxis with post-transplant cyclophosphamide (PTCy) results in lower relapse rates and improved DFS when compared to haplo bone marrow transplant (BMT) with PTCy. However, PBSCT leads to higher rates of GVHD. It is unknown whether the benefits of haplo PBSCT may be nullified in older patients (>60 years) by a higher susceptibility to GVHD and transplant related toxicity.
View Article and Find Full Text PDF[Hematopoietic Transplantation Outcomes in Patients with HLA-Identical, Haploidentical, and Unrelated Donors at a University Hospital in Chile].
Rev Med Chil
September 2024
Red UC Christus, Pontificia Universidad Católica de Chile, Santiago, Chile.
Unlabelled: Allogeneic transplantation (HSCT) is a curative option for several hematological diseases. Our center has privileged the use of identical family donors (IFD) or haploidentical (HD) donors. However, the chances of finding family donors may be challenging in small families or unsuitable donors.
View Article and Find Full Text PDFThe Association of HLA-E Ligand and NKG2 Receptor Variation With Relapse and Mortality After Haploidentical Related Donor Transplantation.
Transplant Cell Ther
January 2025
Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, Washington.
Background: Recurrence of blood malignancy is the major cause of mortality after hematopoietic cell transplantation. NKG2 receptor/HLA-E ligand complexes play a fundamental role in the surveillance and elimination of transformed cells but their role in the control of leukemia in transplantation is unknown.
Objective: We tested the hypothesis that gene variation of patient and/or donor HLA-E ligand and donor NKG2C-NKG2A receptors are associated with the risks of relapse and mortality (primary endpoints) and GVHD and non-relapse mortality (secondary endpoints) after haploidentical transplantation.
A 66-year-old woman was diagnosed with chronic lymphocytic leukemia (CLL) due to the finding of leukocytosis and started acalabrutinib and obinutuzumab (AO) therapy. After three cycles of AO therapy, she developed severe pancytopenia with hypoplastic bone marrow and was diagnosed with fulminant aplastic anemia (AA) due to neutropenia with no response to granulocyte colony-stimulating factor. One month after the onset of AA, she received HLA-haploidentical allogeneic hematopoietic stem cell transplantation (haplo-SCT) from a daughter using FluMelTBI (fludarabine 180 mg/m, melphalan 80 mg/m, total body irradiation 4 Gy) as the conditioning regimen and tacrolimus, mycophenolate mofetil, and post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis.
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