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Low incidence of hemorrhagic cystitis following ex vivo T-cell depleted haploidentical hematopoietic cell transplantation in children

Jepsen, Caroline ; Turkiewicz, Dominik ; Ifversen, Marianne ; Heilmann, Carsten ; Toporski, Jacek LU ; Dykes, Josefina LU ; Mellgren, Karin and Jan Pronk, Cornelis (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.

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publishing date
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
  • pmid:31527820
  • scopus:85073835065
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}},
}