[Indications and management of hematologic microtransplantation: Recommendations of the French Society of Bone Marrow transplantation and cellular Therapy (SFGM-TC)].

Cornillon J; Carre M; Chalandon Y; Chevallier P; Coman T; Harif M; Labuissière-Wallet H; Mear JB; Picard C; Yakoub-Agha I; Srour M

doi:10.1016/j.bulcan.2020.03.016

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[Indications and management of hematologic microtransplantation: Recommendations of the French Society of Bone Marrow transplantation and cellular Therapy (SFGM-TC)].

Cornillon J Institut de cancérologie Lucien-Neuwirth, département d'hématologie et de thérapie cellulaire, 108, bis, avenue Albert-Raimond, 42271 Saint-Priest en Jarez, France. Electronic address: jerome.Cornillon@icloire.fr.
Carre M CHU de Grenoble, clinique universitaire d'hématologie, boulevard de la Chantourne, 38700 La Tronche, France.
Chalandon Y Hôpitaux universitaires Genève, université de Genève, faculté de médecine, service d'hématologie, département d'oncologie, Genève, Suisse.
Chevallier P CHU de hôtel-dieu, service d'hématologie clinique, place A. Ricordeau, 44093 Nantes cedex, France.
Coman T Institut Gustave-Roussy, département d'hématologie, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
Harif M Faculté de médecine et de pharmacie, 19, rue Tariq Ben Zayad, Casablanca, Maroc.
Labuissière-Wallet H Hospices civils de Lyon, centre hospitalier Lyon sud, service d'hématologie, Pierre Bénite, France.
Mear JB CHU de Renens, service d'hématologie clinique, 2, avenue Louis-Guilloux, 35000 Rennes, France.
Picard C Établissement français du sang, EFS PACA-Corse, laboratoire HLA/HPA, Marseille, France.
Yakoub-Agha I Hôpital Huriez, CHRU de Lille, maladie du sang, 3, rue Michel-Polonowsky, 59000 Lille, France.
Srour M Hôpital Huriez, CHRU de Lille, maladie du sang, 3, rue Michel-Polonowsky, 59000 Lille, France.

2020-06-21

Published in:

Bulletin du cancer. - 2020

English Microtransplantation (MT) is based on injection of HLA-mismatched G-CSF mobilized hematopoietic stem cells, in combination with chemotherapy but without use of conditioning regimen nor immunosuppressive drugs. As a result, a transient microchimerism is induced without engraftment. Its efficacy relies both on host immune system stimulation (recipient versus tumor) and on a graft versus tumor effect. Data are scarce and concern mostly Asian patients with acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (HR-MDS). In comparison to conventional treatment without MT, higher complete remission rates and longer disease free survival and overall survival have been reported. Safety seems acceptable. The most frequent adverse event is non-severe cytokine release syndrome. Risk of GVHD remains very low. Here, we summarize the published data and detail the practical aspects of the procedure. Current data are not strong enough to provide recommendations on indications. Nevertheless, it seems reasonable to propose MT to patients with AML or HR-MDS, regardless of age, presenting an indication for allogeneic stem cell transplantation but ineligible for it. MT is still under investigation and rather be proposed within clinical trials.

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