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Peripheral blood stem cell versus bone marrow graft for patients ≥60 years undergoing reduced intensity conditioning haploidentical transplantation for acute myeloid leukemia in complete remission: An analysis of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

R. Devillier, JE. Galimard, D. Blaise, AM. Raiola, S. Bramanti, G. Grillo, R. Pastano, RP. de Latour, A. Busca, L. López-Corral, AB. Rodríguez, C. Schmid, E. Forcade, J. Vydra, C. Solano, G. Bug, A. Neubauer, A. Charbonnier, E. Brissot, A....

. 2024 ; 99 (7) : 1250-1256. [pub] 20240523

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, srovnávací studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc24013356

In the context of T-cell replete haploidentical stem cell transplantation (Haplo-SCT) using post-transplantation cyclophosphamide (PT-Cy), it is still unknown whether peripheral blood (PB) or bone marrow (BM) is the best graft source. While PB is associated with a higher incidence of graft-versus-host disease (GVHD), it may induce a stronger graft-versus-leukemia effect compared to BM, notably in acute myeloid leukemia (AML). From the EBMT registry database, we compared T-cell replete PB (n = 595) versus BM (n = 209) grafts in a large cohort of 804 patients over the age of 60 years who underwent Haplo-SCT with PT-Cy for an AML in first or second complete remission. The risk of acute GVHD was significantly higher in the PB group (Grade II-IV: HR = 1.67, 95% CI [1.10-2.54], p = 0.01; Grade III-IV: HR = 2.29, 95% CI [1.16-4.54], p = 0.02). No significant difference was observed in chronic GVHD or non-relapse mortality. In the PB group, the risk of relapse was significantly lower in the PB group (HR = 0.65, 95% CI [0.45-0.94], p = 0.02) and leukemia-free survival was significantly better (HR = 0.76, 95% CI [0.59-0.99], p = 0.04), with a trend toward better overall survival (HR = 0.78, 95% CI [0.60-1.01], p = 0.06). We conclude that in the specific context of Haplo-SCT with PT-Cy, PB grafts represent a valid option to decrease the risk of relapse and improve outcome of older AML patients who usually do not benefit from conditioning intensification.

CHU Bordeaux Hôpital Haut Lévêque Pessac Bordeaux France

Department of Hematology and Bone Marrow Transplantation Grande Ospedale Metropolitano Niguarda Milan Italy

Department of Hematology BMT Hopital St Louis Université de Paris Cité Paris France

EBMT Statistical Unit Paris France

Ematologia e Terapie Cellulari IRCCS Ospedale Policlinico San Martino Genova Italy

Goethe Universitaet Medizinische Klinik 2 Hämatologie Medizinische Onkologie Frankfurt Main Germany

Hematology Division Chaim Sheba Medical Center Tel Hashomer Israel

Hospital Clínico de Valencia Servicio de Hematología Valencia Valencia Spain

Hospital Clínico Servicio de Hematología Salamanca Spain

Hospital U Marqués de Valdecilla Servicio de Hematología Hemoterapia Santander Spain

Institute of Hematology and Blood Transfusion Prague Czech Republic

IRCCS Ospedale San Raffaele Milan Italy

Klinikum Augsburg 2 Medizinische Klinik Augsburg Germany

Onco Haematology Division European Institute of Oncology IRCCS IEO Milan Italy

Philipps Universitaet Marburg University Hospital Giessen and Marburg Marburg Germany

S S Trapianto di Cellule Staminali A O U Citta della Salute e della Scienza di Torino Torino Italy

Saint Antoine University Hospital Paris France

Transplantation and Cell Therapy Program Institut Paoli Calmettes Marseille Centre de Recherche en Cancérologie de Marseille Aix Marseille University Marseille France

Transplantation Unit Department of Oncology and Haematology IRCCS Humanitas Research Hospital Milan Italy

University of Amiens CHU Amiens Service d'Hematologie Amiens France

Citace poskytuje Crossref.org

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