A clinical trial conducted at the Kimmel Cancer Center at Jefferson testing its unique, two-step half-match procedure has produced some promising results.
The probability of overall survival was 45 percent in all patients after three years and 75 percent in patients who were in remission at the time of the transplant.
AdvertisementNeal Flomenberg, M.D., Chair of the Department of Medical Oncology at Thomas Jefferson University Hospital, Dolores Grosso, DNP, Co-Principal Investigator and lead author of the article, and colleagues discuss the results of 27 patients treated on this phase I/II trial who had diagnoses that included leukaemia, lymphoma and myelodysplasia.
The patients received their transplant in two steps. First, after receiving radiation therapy to further treat their disease, the patients were given a specified dose of T cells (a type of immune cell that fights infection) from their half-matched family donor. The donors were parents, siblings or children of the patient.
The patients next received the drug cyclophosphamide to help the newly infused donor T cells to be more tolerant to the patient's body.
The second step of the transplant occurred when the patients received a dose of their donors' stem cells to help their blood counts return to normal and further strengthen their new immune system.
Dr. Flomenberg and his team found that after a follow-up of 28-56 months, overall survival for the patients after one year was 54 percent and 48 percent at three years.
Patients in remission at the time of the transplant fared better with an overall survival of 75 percent. Seventeen of the 27 patients-with a median age of 52 years old-were alive six months after their transplant, which was the official end point of the trial.
"Our half-match bone marrow transplant results open up many doors for different types of patients who can't find an exact match," said Dr. Flomenberg.
"It also justifies recommending that patients at high risk for relapse should consider having a half-match transplant early in the treatment of their disease.
"Jefferson's two-step procedure provides promising results that could serve as the basis for further exploration and optimisation of the technique," he added.
The findings have been published in the journal Blood.
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