Low incidence of hemorrhagic cystitis following ex vivo T-cell depleted haploidentical hematopoietic cell transplantation in children
(2020) In Bone Marrow Transplantation 55(1). p.207-214- Abstract
Hemorrhagic cystitis (HC) is a debilitating complication following allogenic hematopoietic cell transplantation (HCT). HLA disparity and T-cell depletion have been implicated as risk factors for HC. However, reports on the incidence and risk factors for HC in ex vivo T-cell depleted haploidentical HCT (haploHCT) in children are lacking. We studied 96 haploHCT procedures performed in 83 children between 2002 and 2017. Sixty-three patients were diagnosed with a malignant disease and 20 with nonmalignant disease. All but three patients with SCID underwent myelotoxic and/or lymphotoxic conditioning therapy. Grafts were CD3+ (36.5%) or TcRαβ+ (63.5%) depleted to prevent graft versus host disease (GvHD). Fourteen patients (14.6%) were... (More)
Hemorrhagic cystitis (HC) is a debilitating complication following allogenic hematopoietic cell transplantation (HCT). HLA disparity and T-cell depletion have been implicated as risk factors for HC. However, reports on the incidence and risk factors for HC in ex vivo T-cell depleted haploidentical HCT (haploHCT) in children are lacking. We studied 96 haploHCT procedures performed in 83 children between 2002 and 2017. Sixty-three patients were diagnosed with a malignant disease and 20 with nonmalignant disease. All but three patients with SCID underwent myelotoxic and/or lymphotoxic conditioning therapy. Grafts were CD3+ (36.5%) or TcRαβ+ (63.5%) depleted to prevent graft versus host disease (GvHD). Fourteen patients (14.6%) were diagnosed with HC; 12 (12.5%) had clinically significant stage II–IV HC. All patients with HC had BK viruria and/or viremia. Increasing age and chemotherapeutic treatment prior to conditioning were identified as risk factors for HC. Immune recovery did not significantly differ between patients with and without HC. Thus, we report a low incidence of HC in pediatric haploHCT using ex vivo T-cell depletion. The combination of a reduced toxicity conditioning regimen, and typically absent pharmaceutical post-HCT GvHD prophylaxis in our patients might have contributed to the decreased the risk of HC, despite HLA disparity.
(Less)
- author
- Jepsen, Caroline ; Turkiewicz, Dominik ; Ifversen, Marianne ; Heilmann, Carsten ; Toporski, Jacek LU ; Dykes, Josefina LU ; Mellgren, Karin and Jan Pronk, Cornelis
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Bone Marrow Transplantation
- volume
- 55
- issue
- 1
- pages
- 207 - 214
- publisher
- Nature Publishing Group
- external identifiers
-
- scopus:85073835065
- pmid:31527820
- ISSN
- 0268-3369
- DOI
- 10.1038/s41409-019-0672-4
- language
- English
- LU publication?
- no
- id
- 72730c8d-d9a8-4e86-ae32-6b782cd8a483
- date added to LUP
- 2019-11-01 11:14:38
- date last changed
- 2024-09-18 12:59:12
@article{72730c8d-d9a8-4e86-ae32-6b782cd8a483,
abstract = {{<p>Hemorrhagic cystitis (HC) is a debilitating complication following allogenic hematopoietic cell transplantation (HCT). HLA disparity and T-cell depletion have been implicated as risk factors for HC. However, reports on the incidence and risk factors for HC in ex vivo T-cell depleted haploidentical HCT (haploHCT) in children are lacking. We studied 96 haploHCT procedures performed in 83 children between 2002 and 2017. Sixty-three patients were diagnosed with a malignant disease and 20 with nonmalignant disease. All but three patients with SCID underwent myelotoxic and/or lymphotoxic conditioning therapy. Grafts were CD3+ (36.5%) or TcRαβ+ (63.5%) depleted to prevent graft versus host disease (GvHD). Fourteen patients (14.6%) were diagnosed with HC; 12 (12.5%) had clinically significant stage II–IV HC. All patients with HC had BK viruria and/or viremia. Increasing age and chemotherapeutic treatment prior to conditioning were identified as risk factors for HC. Immune recovery did not significantly differ between patients with and without HC. Thus, we report a low incidence of HC in pediatric haploHCT using ex vivo T-cell depletion. The combination of a reduced toxicity conditioning regimen, and typically absent pharmaceutical post-HCT GvHD prophylaxis in our patients might have contributed to the decreased the risk of HC, despite HLA disparity.</p>}},
author = {{Jepsen, Caroline and Turkiewicz, Dominik and Ifversen, Marianne and Heilmann, Carsten and Toporski, Jacek and Dykes, Josefina and Mellgren, Karin and Jan Pronk, Cornelis}},
issn = {{0268-3369}},
language = {{eng}},
number = {{1}},
pages = {{207--214}},
publisher = {{Nature Publishing Group}},
series = {{Bone Marrow Transplantation}},
title = {{Low incidence of hemorrhagic cystitis following ex vivo T-cell depleted haploidentical hematopoietic cell transplantation in children}},
url = {{http://dx.doi.org/10.1038/s41409-019-0672-4}},
doi = {{10.1038/s41409-019-0672-4}},
volume = {{55}},
year = {{2020}},
}