HLA-haploidentical stem cell transplantation for chronic granulomatous disease: an EBMT-IEWP retrospective study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Quentin Riller - , Necker–Enfants Malades Hospital (Author)
  • Mathias Hauri - , University of Zurich (Author)
  • Su Han Lum - , Newcastle University (Author)
  • Jeroen Knippenberg - , European Society for Blood and Marrow Transplantation (Author)
  • Tiarlan Sirait - , European Society for Blood and Marrow Transplantation (Author)
  • Alexandra Laberko - , Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology (Author)
  • Khalid Halahleh - , King Hussein Cancer Center (Author)
  • Hasan Hashem - , King Hussein Cancer Center (Author)
  • Musa Karakukcu - , Erciyes University (Author)
  • Henrik Sengeloev - , Righospitalet (Author)
  • Fulvio Porta - , University of Brescia (Author)
  • Bénédicte Bruno - , University Hospital of Lille (Author)
  • Marco Zecca - , IRCCS Fondazione Policlinico San Matteo - Pavia (Author)
  • Serap Aksoylar - , Ege University (Author)
  • Vincent Barlogis - , Aix-Marseille Université (Author)
  • Catharina Schuetz - , Department of Paediatrics, German Center for Child and Adolescent Health (DZKJ) - Partner Site Leipzig/Dresden (Author)
  • Jochen Buechner - , University of Oslo (Author)
  • Maura Faraci - , IRCCS Istituto Giannina Gaslini - Genova (Author)
  • Claudia Wehr - , University Medical Center Freiburg (Author)
  • Wolfgang Holter - , Medical University of Vienna (Author)
  • Karin Mellgren - , Queen Silvia Children's Hospital, University of Gothenburg (Author)
  • Franco Locatelli - , Catholic University of the Sacred Heart (Author)
  • Antonio Perez Martinez - , La Paz University Hospital (Author)
  • Felipe Suarez - , Necker–Enfants Malades Hospital (Author)
  • Despina Moshous - , Necker–Enfants Malades Hospital (Author)
  • Andrew R. Gennery - , Newcastle University (Author)
  • Dmitry Balashov - , Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology (Author)
  • Michael H. Albert - , Ludwig Maximilian University of Munich (Author)
  • Mary Slatter - , Newcastle University (Author)
  • Tayfun Güngör - , University of Zurich (Author)
  • Bénédicte Neven - , Necker–Enfants Malades Hospital (Author)

Abstract

Chronic granulomatous disease (CGD) is an inborn error of immunity characterized by defective NAD phosphate oxidase function, leading to impaired microbial killing, recurrent infections, and granulomatous inflammation. Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment for CGD, particularly effective when a fully HLA-matched donor is available. However, the place of HLA-haploidentical HSCT remains less established. This retrospective multicenter study analyzed outcomes of 64 patients with CGD (53 males; 46 with X-linked CGD) who underwent a first HSCT with HLA-haploidentical family donors, with either in vitro T-cell receptor (TCR)αβ/CD19 depletion or in vivo depletion using posttransplant cyclophosphamide (PTCY). The mean age at transplant was 5.8 years (range, 0-33). Patients exhibited a high disease burden before HSCT, with 45% experiencing infections in the 6 months before HSCT and 67% exhibiting inflammation. Outcomes in the entire cohort showed a 3-year overall survival, event-free survival (EFS), and grade 3 to 4 graft-versus-host disease (GVHD)–free EFS of 75.9%, 70.2%, and 56.1%, respectively, and were not affected by the type of depletion or age. The cumulative incidence (CI) of primary graft failure (PGF) was 20.6%. The CI of grade 2 to 4 acute GVHD was higher in the PTCY group (P =.04), whereas the CI of grade 3 to 4 GVHD was not. These results indicate that HLA-haploidentical HSCT is a feasible transplant option for patients with CGD lacking HLA-matched donors. Further refinement of transplant protocols is necessary to mitigate graft failure and acute GVHD, ultimately improving access and outcomes for this life-saving therapy.

Details

Original languageEnglish
Pages (from-to)2518-2527
Number of pages10
JournalBlood
Volume145
Issue number21
Publication statusPublished - 22 May 2025
Peer-reviewedYes

External IDs

PubMed 40090009
ORCID /0009-0003-6519-0482/work/196687565

Keywords