학술논문

Stable to improved cardiac and pulmonary function in children with high-risk sickle cell disease following haploidentical stem cell transplantation.
Document Type
article
Source
Bone marrow transplantation. 56(9)
Subject
Lung
Humans
Anemia
Sickle Cell
Vital Capacity
Hematopoietic Stem Cell Transplantation
Prospective Studies
Child
Sickle Cell Disease
Clinical Research
Transplantation
Rare Diseases
Pediatric
Stem Cell Research
Hematology
Clinical Trials and Supportive Activities
Respiratory
Clinical Sciences
Oncology and Carcinogenesis
Immunology
Language
Abstract
Children with sickle cell disease (SCD) are at high-risk of progressive, chronic pulmonary and cardiac dysfunction. In this prospective multicenter Phase II trial of myeloimmunoablative conditioning followed by haploidentical stem cell transplantation in children with high-risk SCD, 19 patients, 2.0-21.0 years of age, were enrolled with one or more of the following: history of (1) overt stroke; (2) silent stroke; (3) elevated transcranial Doppler velocity; (4) multiple vaso-occlusive crises; and/or (5) two or more acute chest syndromes and received haploidentical transplants from 18 parental donors. Cardiac and pulmonary centralized cores were established. Pulmonary function results were expressed as percent of the median of healthy reference cohorts, matched for age, sex, height and race. At 2 years, pulmonary functions including forced expiratory volume (FEV), FEV1/ forced vital capacity (FVC), total lung capacity (TLC), diffusing capacity of lung for carbon monoxide (DLCO) were stable to improved compared to baseline values. Importantly, specific airway conductance was significantly improved at 2 years (p