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Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT
MA. Kharfan-Dabaja, M. Labopin, E. Ayala, A. Bazarbachi, D. Blaise, J. Vydra, S. Bramanti, M. Itälä-Remes, C. Schmid, A. Busca, E. Forcade, W. Rabitsch, M. Zecca, N. Kröger, CE. Bulabois, G. Grillo, A. Rambaldi, R. Fanin, F. Zallio, N. Di Renzo,...
Status neindexováno Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 2017
PubMed Central
od 2017
Europe PubMed Central
od 2017
Wiley-Blackwell Open Access Titles
od 1997
- Publikační typ
- časopisecké články MeSH
Availability of haploidentical donors has broadened utilization of allogeneic hematopoietic cell transplantation (allo-HCT). Peripheral blood stem cells (PBSC) are being used with increased frequency in haploidentical allo-HCT. We evaluated extent of HLA disparity (2-3/8 versus 4/8 HLA antigen mismatches) on post-allograft outcomes when using T-cell replete PBSC from haploidentical donors for acute myeloid leukemia in first complete remission. Primary objectives entailed assessing cumulative incidence of grade 2-4 acute graft-versus-host disease (GVHD) and chronic GVHD (any grade). A total of 645 patients received a haploidentical allo-HCT from a donor with either 2-3 of 8 HLA antigen mismatches (n = 180) or with 4 of 8 HLA antigen mismatches (n = 465). Presence of 2-3 of 8 versus 4 of 8 HLA mismatches did not affect the incidence of acute GVHD (grade 2-4) and chronic GVHD (any grade). Overall survival (OS), leukemia-free survival (LFS) relapse incidence (RI), nonrelapse mortality and the composite endpoint of GVHD-free relapse-free survival were also similar among the groups. Pertaining to HLA-B leader matching effect, our analysis did not discern any difference in aforementioned post-allograft outcomes for this variable. However, in univariate analysis, absence of an antigen mismatch in HLA-DPB1 showed a trend for better OS. Notwithstanding inherent limitations associated with registry data, our results did not show an advantage of selecting a haploidentical donor with 2-3 of 8 HLA antigen mismatches over one with 4 of 8 HLA antigen mismatches when using PBSC as the cell source. Adverse cytogenetics remains a major adverse determinant of inferior OS and LFS and a higher RI. Using reduced-intensity conditioning yielded worse OS and LFS.
Acute Leukemia Working Party of EBMT Paris France
Alberts Cellular Therapy Netcare Pretoria East Hospital Pretoria South Africa
ASST Grande Ospedale Metropolitano Niguarda Hematology Department Milano Italy
Augsburg University Hospital and Medical Faculty Augsburg Germany
Azienda Ospedaliero Universitaria di Udine Division of Hematology Italy
CHU Grenoble Alpes Université Grenoble Alpes Service d`Hématologie France
Department of Hematology Hôpital Saint Antoine Sorbonne University and INSERM UMRs 938 Paris France
H SS Antonio e Biagio Haematology Department Alessandria Italy
Hospital Sirio Libanes Hematology Bone Marrow Transplant Unit Sao_Paulo Brazil
Institute of Hematology and Blood Transfusion Prague Czech Republic
IRCCS Istituto Clinico Humanitas Rozzano Milano Italy
Medicana International Hospital Istanbul Bone Marrow Transplant Unit Istanbul Turkey
Ospedale San Raffaele s r l Haematology and BMT Milano Italy
Paediatric Haematology Oncology Fondazione IRCCS Policlinico San Matteo Pavia Italy
Reina Sofia University Hospital IMIBIC University of Cordoba Spain
S S C 5 D Trapianto di Cellule Staminali A O U Citta della Salute e della Scienza di Torino Italy
Service d'Hématologie Clinique et Thérapie Cellulaire CHU Bordeaux France
Turku University Hospital TD7 Turku Finland
Unita Operativa di Ematologia e Trapianto di cellule staminali Lecce Italy
University Hospital Eppendorf Bone Marrow Transplantation Centre Hamburg Germany
Citace poskytuje Crossref.org
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