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      Outcome of children with acute leukemia given HLA-haploidentical HSCT after αβ T-cell and B-cell depletion

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          Key Points

          Children with AL given haplo-HSCT after αβ T- and B-cell depletion are exposed to a low risk of acute and chronic GVHD and NRM. The leukemia-free, GVHD-free survival of patients given this type of allograft is comparable to that of HLA-matched donor HSCT recipients.

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          Most cited references59

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          Nonparametric Estimation from Incomplete Observations

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            A Class of $K$-Sample Tests for Comparing the Cumulative Incidence of a Competing Risk

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              Effectiveness of donor natural killer cell alloreactivity in mismatched hematopoietic transplants.

              T cells that accompany allogeneic hematopoietic grafts for treating leukemia enhance engraftment and mediate the graft-versus-leukemia effect. Unfortunately, alloreactive T cells also cause graft-versus-host disease (GVHD). T cell depletion prevents GVHD but increases the risk of graft rejection and leukemic relapse. In human transplants, we show that donor-versus-recipient natural killer (NK)-cell alloreactivity could eliminate leukemia relapse and graft rejection and protect patients against GVHD. In mice, the pretransplant infusion of alloreactive NK cells obviated the need for high-intensity conditioning and reduced GVHD. NK cell alloreactivity may thus provide a powerful tool for enhancing the efficacy and safety of allogeneic hematopoietic transplantation.
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                Author and article information

                Journal
                Blood
                American Society of Hematology
                0006-4971
                1528-0020
                August 03 2017
                August 03 2017
                : 130
                : 5
                : 677-685
                Affiliations
                [1 ]Department of Pediatric Hematology and Oncology, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Bambino Gesù, Rome, Italy;
                [2 ]Department of Pediatric Science, Università di Pavia, Pavia, Italy;
                [3 ]Dipartimento di Ricerca e Diagnostica, UOC Immunologia Clinica e Sperimentale, Istituto di Ricovero e Cura a Carattere Scientifico Giannina Gaslini, Genoa, Italy;
                [4 ]UOC Immunologia, Ospedale Policlinico San Martino, Genoa, Italy;
                [5 ]Department of Pediatrics, Sant’Orsola Hospital, University of Bologna, Bologna, Italy;
                [6 ]Department of Radiotherapy, Policlinico Umberto I, Rome, Italy;
                [7 ]Department of Pediatric Hematology and Oncology, Children's University Hospital, University of Tuebingen, Tuebingen, Germany;
                [8 ]Dipartimento di Medicina Sperimentale and Centro di Eccellenza per la Ricerca Biomedica, Università di Genova, Genoa, Italy; and
                [9 ]Immunology Research Area, IRCCS Ospedale Bambino Gesù, Rome, Italy
                Article
                10.1182/blood-2017-04-779769
                28588018
                ee50874c-55af-4fa4-b9b0-d030b9cd0581
                © 2017
                History

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