Transplantation characteristics of group A (patients with malignant diseases)
| No . | Age, y/sex . | Disease . | Indication for RIT . | Stem cell source* . | RIT BM dose, Gy† . | Conditioning regimen (dose)‡ . | Clinical course after HCT§ . | Disease status after HCT . | Survival status . |
|---|---|---|---|---|---|---|---|---|---|
| A-1 | 17/F | AML M5 CR3 | Advanced disease (2nd relapse); 2nd HCT | MUD/PBSC | 28 | TBI (12 Gy), Flu (160), ATG | Pericardial effusion; resuscitation; apallic syndrome; died of infection | CR | Dead (d +129) |
| A-2 | 9/M | AML M1/2 CR2 | Advanced disease (early relapse); pulmonary disease | MSD/BM | 19 | TBI (12 Gy), Flu (160) | Acute GVHD (4th degree); chronic GVHD (extended/severe) | CR | Alive (> 72 mo) |
| A-3 | 5/M | ALL CR2 (cortical T) | Advanced disease (early combined relapse) | MFD/BM | 15 | TBI (12 Gy), VP16 (60) | CMV reactivation | CR | Alive (> 63 mo) |
| A-4 | 15/M | AML M0 CR2 | Advanced disease (early relapse) | MUD/BM | 18 | TBI (12 Gy), Flu (160), ATG | Relapse; bacterial sepsis; aspergillosis; died of these complications | Relapse | Dead (d +94) |
| A-5 | 12/M | ALL PR2 | Advanced disease (refractory disease, 10% BM blasts) | MFD/BM | 23 | TBI (12 Gy), VP16 (60) | Fourth-degree toxicity; aspergillus pneumonia; died of multiorgan failure | CR | Dead (d +36) |
| A-6 | 11/M | ALL PR1 | Advanced disease (refractory disease, 25% BM blasts) | MSD/BM | 36 | TBI (14 Gy), VP16 (40) | Died of early relapse | Relapse | Dead (d +37) |
| A-7 | 6/M | ALL NR | Advanced disease (refractory disease, 50% BM blasts) | MMUD/PBSC | 26 | TBI (14 Gy), VP16 (60), ATG | CMV reactivation; chronic GVHD (extended/moderate) after preemptive DLI | CR | Alive (> 25 mo) |
| A-8 | 6/M | AML M0 | Advanced disease (refractory disease, 5% BM blasts) | Haplo/TDPBSC | 46 | Bu Flu (160), Cy (120), ATG OKT3 | Rejection of first graft; re-HSCT from 2nd haplo donor; CMV reactivation; EBV-LPS; BK cystitis | CR | Alive (> 45 mo) |
| A-9 | 21/F | AML M2 PR4 | Advanced disease (3rd relapse, in poor remission) | Haplo/TDPBSC | 11 | Flu (160), Cy (120), ATG OKT3 | CMV reactivation; BK cystitis; acute and chronic GVHD after preemptive DLI | CR | Alive (> 53 mo) |
| A-10 | 7/M | ALL CR2 | Advanced disease (early relapse); systemic aspergillosis | MUD/BM | 35 | Flu (160), Mel (140), ATG | Extramedullary relapse (bone, meninges); CMV reactivation; in treatment (2nd HCT) | Relapse | Alive (> 38 mo) |
| A-11 | 10/M | ALL PR3 | Advanced disease (refractory disease, 10% BM blasts); 2nd HCT | MUD/BM | 34 | Flu (160), Mel (140), ATG | Extramedullary relapse (bone, lymph nodes); died after 3rd haploidentical HCT from relapse | Relapse | Dead (27 mo) |
| A-12 | 14/F | AML M2 CR2 | Advanced disease (early relapse) | MUD/BM | 36 | Flu (160), Mel (140), ATG | Adenovirus infection; BK cystitis; acute third-degree GVHD after preemptive DLI | CR | Alive (> 30 mo) |
| A-13 | 14/F | sMDS | Advanced disease (secondary refractory disease) | MUD/PBSC | 35 | Flu (160), Mel (140), ATG | Early relapse; on treatment | Relapse | Alive (> 20 mo) |
| A-14 | 7/F | Neuroblastoma stage IV | Advanced disease (refractory disease); 2nd HCT | MFD/BM | 26 | Flu (160), Mel (140) | Late relapse; on treatment | Relapse | Alive (> 21 mo) |
| No . | Age, y/sex . | Disease . | Indication for RIT . | Stem cell source* . | RIT BM dose, Gy† . | Conditioning regimen (dose)‡ . | Clinical course after HCT§ . | Disease status after HCT . | Survival status . |
|---|---|---|---|---|---|---|---|---|---|
| A-1 | 17/F | AML M5 CR3 | Advanced disease (2nd relapse); 2nd HCT | MUD/PBSC | 28 | TBI (12 Gy), Flu (160), ATG | Pericardial effusion; resuscitation; apallic syndrome; died of infection | CR | Dead (d +129) |
| A-2 | 9/M | AML M1/2 CR2 | Advanced disease (early relapse); pulmonary disease | MSD/BM | 19 | TBI (12 Gy), Flu (160) | Acute GVHD (4th degree); chronic GVHD (extended/severe) | CR | Alive (> 72 mo) |
| A-3 | 5/M | ALL CR2 (cortical T) | Advanced disease (early combined relapse) | MFD/BM | 15 | TBI (12 Gy), VP16 (60) | CMV reactivation | CR | Alive (> 63 mo) |
| A-4 | 15/M | AML M0 CR2 | Advanced disease (early relapse) | MUD/BM | 18 | TBI (12 Gy), Flu (160), ATG | Relapse; bacterial sepsis; aspergillosis; died of these complications | Relapse | Dead (d +94) |
| A-5 | 12/M | ALL PR2 | Advanced disease (refractory disease, 10% BM blasts) | MFD/BM | 23 | TBI (12 Gy), VP16 (60) | Fourth-degree toxicity; aspergillus pneumonia; died of multiorgan failure | CR | Dead (d +36) |
| A-6 | 11/M | ALL PR1 | Advanced disease (refractory disease, 25% BM blasts) | MSD/BM | 36 | TBI (14 Gy), VP16 (40) | Died of early relapse | Relapse | Dead (d +37) |
| A-7 | 6/M | ALL NR | Advanced disease (refractory disease, 50% BM blasts) | MMUD/PBSC | 26 | TBI (14 Gy), VP16 (60), ATG | CMV reactivation; chronic GVHD (extended/moderate) after preemptive DLI | CR | Alive (> 25 mo) |
| A-8 | 6/M | AML M0 | Advanced disease (refractory disease, 5% BM blasts) | Haplo/TDPBSC | 46 | Bu Flu (160), Cy (120), ATG OKT3 | Rejection of first graft; re-HSCT from 2nd haplo donor; CMV reactivation; EBV-LPS; BK cystitis | CR | Alive (> 45 mo) |
| A-9 | 21/F | AML M2 PR4 | Advanced disease (3rd relapse, in poor remission) | Haplo/TDPBSC | 11 | Flu (160), Cy (120), ATG OKT3 | CMV reactivation; BK cystitis; acute and chronic GVHD after preemptive DLI | CR | Alive (> 53 mo) |
| A-10 | 7/M | ALL CR2 | Advanced disease (early relapse); systemic aspergillosis | MUD/BM | 35 | Flu (160), Mel (140), ATG | Extramedullary relapse (bone, meninges); CMV reactivation; in treatment (2nd HCT) | Relapse | Alive (> 38 mo) |
| A-11 | 10/M | ALL PR3 | Advanced disease (refractory disease, 10% BM blasts); 2nd HCT | MUD/BM | 34 | Flu (160), Mel (140), ATG | Extramedullary relapse (bone, lymph nodes); died after 3rd haploidentical HCT from relapse | Relapse | Dead (27 mo) |
| A-12 | 14/F | AML M2 CR2 | Advanced disease (early relapse) | MUD/BM | 36 | Flu (160), Mel (140), ATG | Adenovirus infection; BK cystitis; acute third-degree GVHD after preemptive DLI | CR | Alive (> 30 mo) |
| A-13 | 14/F | sMDS | Advanced disease (secondary refractory disease) | MUD/PBSC | 35 | Flu (160), Mel (140), ATG | Early relapse; on treatment | Relapse | Alive (> 20 mo) |
| A-14 | 7/F | Neuroblastoma stage IV | Advanced disease (refractory disease); 2nd HCT | MFD/BM | 26 | Flu (160), Mel (140) | Late relapse; on treatment | Relapse | Alive (> 21 mo) |
RIT indicates radioimmunotherapy; F, female; AML, acute myeloid leukemia (M0, M1, M2, and M5 denote subtypes of AML according to the French-American-British classification); CR, complete remission (numbers indicate number of complete remissions; eg, CR2 is second complete remission); MUD, HLA-matched unrelated donor; PBSC, peripheral blood stem cell; Flu, fludarabine; ATG, anti-thymocyte globulin; d +, number of days after transplantation; M, male; MSD, HLA-matched sibling donor; MFD, HLA-matched family donor; VP16, etoposide; PR, partial remission (numbers indicate number of partial remissions; eg, PR2 is second partial remission); fourth-degree toxicity, according to the Bearman classification36 ; NR, no remission; MMUD, HLA-mismatched undated donor; haplo, HLA-haploidentical family donor; TDPBSC, T cell–depleted peripheral blood stem cells; Bu, busulfan; Mel, melphalan; OKT3, anti-CD3 monoclonal antibody; Cy, cyclophosphamide; EBV-LPS, EBV-induced lymphoproliferative syndrome; and sMDS, secondary myelodysplastic syndrome.
TDPBSCs were < 3 × 104 CD3 per kilogram of body weight.
Calculated absorbed doses in BM.
Drugs used in the conditioning regimen were as follows, with doses given in parentheses in the table: fludarabine (mg/m2); etoposide (mg/kg); melphalan (mg/m2); and intravenous busulfan (applied dose was weight adapted according to the prescription of the manufacturer).
GVHD greater than second grade.