Comparison of HLA-mismatched unrelated donor transplantation with post-transplant cyclophosphamide versus HLA-haploidentical transplantation in patients with active acute myeloid leukemia.
[en] 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.
Disciplines :
Hematology
Author, co-author :
Baron, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'hématologie clinique
Labopin, Myriam ; EBMT Paris Study Office/CEREST-TC, Paris, France. ; Service d'Hématologie Clinique, Hôpital Saint-Antoine, AP-HP, Paris, France. ; INSERM UMRs 938, Paris, France. ; Sorbonne University, Paris, France.
Tischer, Johanna; University Hospital of Munich - Campus Grosshadern, LMU, Department of Internal
Ciceri, Fabio ; IRCCS Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy.
Raiola, Anna Maria; Ospedale San Martino, Department of Haematology II, Genova, Italy.
Blaise, Didier ; Programme de Transplantation &Therapie Cellulaire, Département d'hématologie
Sica, Simona; Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, ; Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche,
Vydra, Jan ; Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
Fanin, Renato; Division of Hematology, University Hospital and DAME, Udine, Italy.
Diez-Martin, Jose Luis; Head of Hematology Department, Hospital G U Gregorio Marañon, Instituto de
Bulabois, Claude Eric; CHU Grenoble Alpes - Université Grenoble Alpes, Service d'Hématologie, CS, 10217,
Stölzel, Friedrich ; Universitätsklinikum Carl Gustav Carus Dresden, Medizinische Klinik und
Busca, Alessandro ; S.S.C.V.D Trapianto di Cellule Staminali A.O.U Citta della Salute e della Scienza
Jindra, Pavel ; Department of Hematology/Oncology, Charles University Hospital, Pilsen, Czech
Koc, Yener; Medicana International Hospital Istanbul, Bone Marrow Transplant Unit, Istanbul,
Chevallier, Patrice; CHU Nantes, Department D'Hematologie, Nantes, France.
Forcade, Edouard ; Service d'Hématologie Clinique et Thérapie Cellulaire, CHU Bordeaux, F-33000
Rösler, Wolf; Department of Internal Medicine 5, University Hospital Erlangen, Erlangen,
Passweg, Jakob; University Hospital Hematology, Basel, Switzerland.
Kulagin, Alexander ; RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia.
Carella, Angelo Michele; Ematologia e Centro Trapianti CSE Dipartimento di Scienze Mediche Fondazione
Simand, Celestine; Hematology, ICANS, University Hospital, Strasbourg, France.
Bazarbachi, Ali ; Department of Internal Medicine, American University of Beirut Medical Center
Pioltelli, Pietro; Ospedale San Gerardo, Clinica Ematologica dell'Universita Milano-Biocca, Monza,
Nagler, Arnon ; Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical
Mohty, Mohamad ; EBMT Paris Study Office/CEREST-TC, Paris, France. ; Service d'Hématologie Clinique, Hôpital Saint-Antoine, AP-HP, Paris, France. ; INSERM UMRs 938, Paris, France. ; Sorbonne University, Paris, France.
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