演題詳細

ポスター / Poster

【E】ポスター 43 (Poster 43) :GVHD/Chimerism

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F エメラルドABCD)
座長・司会
岡本 康裕 (Yasuhiro Okamoto):1
1:Department of Pediatrics, Kagoshima University Hospital, Japan
 
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CBT from KIR mismatched donor in refractory pediatric ALL

演題番号 : PS-1-323

岡本 康裕 (Yasuhiro Okamoto):1、西川 拓朗 (Takuro Nishikawa):1、田邊 貴幸 (Takayuki Tanabe):1、八牧 愉二 (Yuni Yamaki):1、倉内 宏一郎 (Koichiro Kurauchi):1、新小田 雄一 (Yuichi Shinkoda):1、児玉 祐一 (Yuichi Kodama):1、中川 俊輔 (Shunsuke Nakagawa):1、河野 嘉文 (Yoshifumi Kawano):1

1:Department of Pediatrics, Kagoshiuma University

 

Background: We reviewed 2 refractory pediatric ALL who underwent allogeneic CBT from KIR mismatched donors. Case report: A 6-year-old boy with high risk ALL achieved CR promptly. Unfortunately he relapsed twice with chemotherapy. He received BMT from HLA-matched sibling, however, he relapsed 5 months post BMT. Prior to CBT his marrow was occupied by 74 % of blast. Conditioning regimen was TBI 6 Gy + Flu 150 mg/m2 + ATG 6 mg/kg + L-PAM 140 mg/m2. KIR mismatched (Cw4 to Cw3) CB containing 3.2 x 105/kg CD34+ cells were transplanted. Engraftment was achieved at day 22. STR at 1 month showed 82 % of donor cells, which expand to 100 % at 2 month and later. Finally, he relapsed at day 145. The second patient was 1.8-year-old boy with standard risk ALL. He completed planned therapy. Seven years from diagnosis, he relapsed in testis. During the chemotherapy, he relapsed again in both testis and bone marrow. He received BMT from HLA-1-locus-mismatched unrelated donor. Five months later, he relapsed. Prior to CBT he had 20 % of blasts in his peripheral blood. Conditioning regimen was Flu 150 mg/m2 + ATG 6 mg/kg. KIR mismatched (Cw4 to Cw3) CB containing 0.7 x 105/kg CD34+ cells were transplanted. Engraftment was achieved, however, bone marrow was hypoplastic at day 30 with 1 % of blast by FACS. Finally, he relapsed at day 56. Discussion: NK cell activity against leukemic blast has been reported to be important in allogeneic transplantation. Although KIR-mismatched CBT to enhance NK activity was effective, more promising strategy is needed to cure these patients.

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