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

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Jepsen, Caroline ; Turkiewicz, Dominik ; Ifversen, Marianne ; Heilmann, Carsten ; Toporski, Jacek ; Dykes, Josefina ; Mellgren, Karin ; Pronk, Cornelis Jan. / Low incidence of hemorrhagic cystitis following ex vivo T-cell depleted haploidentical hematopoietic cell transplantation in children. In: Bone Marrow Transplantation. 2020 ; Vol. 55, No. 1. pp. 207-214.

Bibtex

@article{d4a27e820ea44fe2ab42a82494c5a6f8,
title = "Low incidence of hemorrhagic cystitis following ex vivo T-cell depleted haploidentical hematopoietic cell transplantation in children",
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 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.",
keywords = "Child, Cystitis/etiology, Graft vs Host Disease/etiology, Hematopoietic Stem Cell Transplantation/adverse effects, Humans, Incidence, T-Lymphocytes, Transplantation Conditioning/adverse effects",
author = "Caroline Jepsen and Dominik Turkiewicz and Marianne Ifversen and Carsten Heilmann and Jacek Toporski and Josefina Dykes and Karin Mellgren and Pronk, {Cornelis Jan}",
year = "2020",
doi = "10.1038/s41409-019-0672-4",
language = "English",
volume = "55",
pages = "207--214",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "1",

}

RIS

TY - JOUR

T1 - Low incidence of hemorrhagic cystitis following ex vivo T-cell depleted haploidentical hematopoietic cell transplantation in children

AU - Jepsen, Caroline

AU - Turkiewicz, Dominik

AU - Ifversen, Marianne

AU - Heilmann, Carsten

AU - Toporski, Jacek

AU - Dykes, Josefina

AU - Mellgren, Karin

AU - Pronk, Cornelis Jan

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

KW - Child

KW - Cystitis/etiology

KW - Graft vs Host Disease/etiology

KW - Hematopoietic Stem Cell Transplantation/adverse effects

KW - Humans

KW - Incidence

KW - T-Lymphocytes

KW - Transplantation Conditioning/adverse effects

UR - http://www.scopus.com/inward/record.url?scp=85073835065&partnerID=8YFLogxK

U2 - 10.1038/s41409-019-0672-4

DO - 10.1038/s41409-019-0672-4

M3 - Journal article

C2 - 31527820

VL - 55

SP - 207

EP - 214

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 1

ER -

ID: 58992745