Comparison of HLA-mismatched unrelated donor transplantation with post-transplant cyclophosphamide versus HLA-haploidentical transplantation in patients with active acute myeloid leukemia
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
35978005
DOI
10.1038/s41409-022-01781-9
PII: 10.1038/s41409-022-01781-9
Knihovny.cz E-resources
- MeSH
- Leukemia, Myeloid, Acute * drug therapy MeSH
- Cyclophosphamide therapeutic use MeSH
- Adult MeSH
- Transplantation, Haploidentical adverse effects MeSH
- Humans MeSH
- Graft vs Host Disease * etiology MeSH
- Unrelated Donors MeSH
- Transplantation Conditioning methods MeSH
- Retrospective Studies MeSH
- Hematopoietic Stem Cell Transplantation * methods MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Cyclophosphamide MeSH
HLA-haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HCT) is frequently used as treatment for patients with active acute myeloid leukemia (AML). Here, we investigated whether 9/10 HLA-mismatched unrelated donor transplantation (MMUD-HCT) with post-transplant cyclophosphamide (PTCy) is an adequate alternative. Inclusion criteria in this retrospective registry study consisted of adult patients, first HCT with a Haplo donor or MMUD between 2010 and 2020 using PTCy as graft-versus-host disease (GVHD) prophylaxis, and primary refractory or relapsed disease. MMUD patients were pair-matched 1 to 2 with Haplo-recipients. A total of 73 MMUD patients met the inclusion criteria. Their data were compared to those of 146 Haplo patients in a matched-pair analysis. Median follow-up was 27 months in MMUD patients and 36 months in Haplo recipients. Two-year incidences of relapse and non-relapse mortality (NRM) were 40% and 18% in MMUD patients, respectively, versus 50% (P = 0.23) and 24% (P = 0.18) in Haplo recipients. Two-year leukemia-free survival (LFS) and overall survival (OS) was 42% and 46% in MMUD recipients, respectively, versus 26% (P = 0.1) and 28% (P = 0.061) in Haplo-patients. In conclusions, in AML patients with active disease at transplantation, MMUD-HCT results in at least comparable outcomes to Haplo-HCT when PTCy is applied.
CHU Grenoble Alpes Université Grenoble Alpes Service d'Hématologie CS 10217 Grenoble France
CHU Nantes Department D'Hematologie Nantes France
Department of Hematology Oncology Charles University Hospital Pilsen Czech Republic
Department of Internal Medicine 5 University Hospital Erlangen Erlangen Germany
Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon
Division of Hematology University Hospital and DAME Udine Italy
EBMT Paris Study Office CEREST TC Paris France
Hematology ICANS University Hospital Strasbourg France
Institute of Hematology and Blood Transfusion Prague Czech Republic
IRCCS Ospedale San Raffaele University Vita Salute San Raffaele Milan Italy
Laboratory of Hematology GIGA I3 University of Liege and CHU of Liège Liege Belgium
Medicana International Hospital Istanbul Bone Marrow Transplant Unit Istanbul Turkey
Ospedale San Gerardo Clinica Ematologica dell'Universita Milano Biocca Monza Italy
Ospedale San Martino Department of Haematology 2 Genova Italy
RM Gorbacheva Research Institute Pavlov University St Petersburg Russia
Service d'Hématologie Clinique et Thérapie Cellulaire CHU Bordeaux F 33000 Bordeaux France
Service d'Hématologie Clinique Hôpital Saint Antoine AP HP Paris France
Sorbonne University Paris France
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