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Haploidentical transplantation in primary refractory/relapsed secondary vs de novo AML: from the ALWP/EBMT

A. Nagler, M. Labopin, J. Tischer, AM. Raiola, D. Kunadt, J. Vydra, D. Blaise, P. Chiusolo, R. Fanin, J. Winkler, E. Forcade, G. Van Gorkom, F. Ciceri, M. Mohty

. 2024 ; 8 (15) : 4223-4233. [pub] 20240813

Language English Country United States

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc24019350

We compared the outcomes of haploidentical stem cell transplantation (haplo-HSCT) with posttransplant cyclophosphamide (PTCy) in 719 patients with primary refractory (PR) or first relapse (Rel) secondary acute myeloid leukemia (sAML; n = 129) vs those with de novo AML (n = 590), who received HSCT between 2010 and 2022. A higher percentage of patients with sAML vs de novo AML had PR disease (73.6% vs 58.6%; P = .002). In 81.4% of patients with sAML , the antecedent hematological disorder was myelodysplastic syndrome. Engraftment was 83.5% vs 88.4% in sAML and de novo AML, respectively (P = .13). In multivariate analysis, haplo-HSCT outcomes did not differ significantly between the groups: nonrelapse mortality hazard ratio (HR), 1.38 (95% confidence interval [CI], 0.96-1.98; P = .083), relapse incidence HR, 0.68 (95% CI, 0.4.7.-1.00; P = .051). The HRs for leukemia-free survival, overall survival, and graft-versus-host disease (GVHD)-free, and GVHD and relapse-free survival were 0.99 (95% CI, 0.76-1.28; P = .94), 0.99 (95% CI, 0.77-1.29; P = .97), and 0.99 (95% CI, 0.77-1.27; P = .94), respectively. We conclude that outcomes of haplo-HSCT with PTCy are not different for PR/Rel sAML in comparison with PR/Rel de novo AML, a finding of major clinical importance.

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$a We compared the outcomes of haploidentical stem cell transplantation (haplo-HSCT) with posttransplant cyclophosphamide (PTCy) in 719 patients with primary refractory (PR) or first relapse (Rel) secondary acute myeloid leukemia (sAML; n = 129) vs those with de novo AML (n = 590), who received HSCT between 2010 and 2022. A higher percentage of patients with sAML vs de novo AML had PR disease (73.6% vs 58.6%; P = .002). In 81.4% of patients with sAML , the antecedent hematological disorder was myelodysplastic syndrome. Engraftment was 83.5% vs 88.4% in sAML and de novo AML, respectively (P = .13). In multivariate analysis, haplo-HSCT outcomes did not differ significantly between the groups: nonrelapse mortality hazard ratio (HR), 1.38 (95% confidence interval [CI], 0.96-1.98; P = .083), relapse incidence HR, 0.68 (95% CI, 0.4.7.-1.00; P = .051). The HRs for leukemia-free survival, overall survival, and graft-versus-host disease (GVHD)-free, and GVHD and relapse-free survival were 0.99 (95% CI, 0.76-1.28; P = .94), 0.99 (95% CI, 0.77-1.29; P = .97), and 0.99 (95% CI, 0.77-1.27; P = .94), respectively. We conclude that outcomes of haplo-HSCT with PTCy are not different for PR/Rel sAML in comparison with PR/Rel de novo AML, a finding of major clinical importance.
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$a Labopin, Myriam $u Department of Haematology, EBMT Paris Study Office, Saint Antoine Hospital, INSERM UMR 938, Sorbonne University, Paris, France $u Department of Hematology, Sorbonne University, Saint Antoine Hospital, INSERM UMR 938, Paris, France
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$a Tischer, Johanna $u Klinikum Grosshadern, Munich, Germany
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$a Raiola, Anna Maria $u IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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$a Kunadt, Desiree $u University Hospital TU Dresden, Dresden, Germany
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$a Vydra, Jan $u Institute of Hematology and Blood Transfusion, Prague, Czech Republic $1 https://orcid.org/0000000242743895
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$a Blaise, Didier $u Programme de Transplantation & Therapie Cellulaire, Marseille, France $1 https://orcid.org/0000000256849447
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$a Chiusolo, Patrizia $u Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico A. Gemelli IRCCS, Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy $1 https://orcid.org/0000000213551587
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$a Fanin, Renato $u Azienda Ospedaliero Universitaria di Udine, Udine, Italy
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$a Winkler, Julia $u University Hospital Erlangen, Erlangen, Germany
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$a Forcade, Edouard $u CHU Bordeaux, Hopital Haut-Leveque, Pessac, France
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$a Van Gorkom, Gwendolyn $u University Hospital Maastricht, Maastricht, The Netherlands
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$a Ciceri, Fabio $u Ospedale San Raffaele, Haematology and Bone Marrow Transplantation, Milan, Italy
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$a Mohty, Mohamad $u Department of Haematology, EBMT Paris Study Office, Saint Antoine Hospital, INSERM UMR 938, Sorbonne University, Paris, France $u Department of Hematology, Sorbonne University, Saint Antoine Hospital, INSERM UMR 938, Paris, France
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