[en] The association between graft-versus-host disease (GVHD) occurrence and acute myeloid leukemia (AML) relapse in patients treated with HLA-haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HCT) with post-transplant cyclophosphamide (PTCy)-based GVHD prophylaxis has remained debated. Here, we addressed this issue in patients with active AML at transplantation. 2-year cumulative incidences of relapse and leukemia-free survival (LFS) were 49% and 32.3%, respectively. There were no associations between acute nor chronic GVHD of any grade and lower relapse incidence. However, grade I acute GVHD was associated with better LFS (HR = 0.71, 95% CI 0.51-0.99, P = 0.04). In contrast, grade III-IV acute (HR = 3.09, 95% CI 1.87-5.12, P < 0.0001) as well as extensive chronic (HR = 3.3, 95% CI 1.81-6.04, P = 0.0001) GVHD correlated with higher nonrelapse mortality leading to lower LFS (HR = 1.36, 95% CI 0.99-1.86, P = 0.056 and HR = 1.97, 95% CI 1.35-2.89, P = 0.0004, respectively). In conclusion, these data suggest a dissociation of graft-versus-leukemia effects from GVHD in patients with active AML treated with PTCy-based Haplo-HCT.
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 ; Department of Hematology, Saint Antoine Hospital, Paris, France ; INSERM UMR 938, Paris, France ; Sorbonne University, Paris, France
Tischer, Johanna; Department of Internal Medicine III, LMU, University Hospital of Munich, Campus Grosshadern, Munich, Germany
Raiola, Anna Maria; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
Vydra, Jan; Institute of Hematology and Blood Transfusion, Prague, Czech Republic
Blaise, Didier; Programme de Transplantation et d'immunothérapie Cellulaire, Management Sport Cancer Lab, Institut Paoli Calmettes, Aix Marseille University, Marseille, France
Chiusolo, Patrizia; Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Stölzel, Friedrich; University Hospital Dresden, Medizinische Klinik und Poliklinik, TU Dresden, Dresden, Germany ; University Hospital Schleswig-Holstein, Kiel, Germany
Fanin, Renato; Division of Hematology, Azienda Ospedaliero Universitaria di Udine, Udine, Italy
Chevallier, Patrice; Dept. D`Hematologie, CHU Nantes, Nantes, France
Nagler, Arnon; Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
Ciceri, Fabio; Haematology and BMT, Ospedale San Raffaele S.R.L., Milan, Italy
Mohty, Mohamad; EBMT Paris Study Office/CEREST-TC, Paris, France ; Department of Hematology, Saint Antoine Hospital, Paris, France ; INSERM UMR 938, Paris, France ; Sorbonne University, Paris, France
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