Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation : An EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine
Giannotti, Federica (Saint-Antoine Hospital)
Labopin, Myriam (Hôpital Saint-Antoine (Paris, França))
Shouval, Roni (Chaim Sheba Medical Center (Israel))
Sanz, Jaime (Instituto de Salud Carlos III)
Arcese, William (Rome Transplant Network tor Vergatä)
Angelucci, Emanuele (Ospedale Policlinico San Martino)
Malouf Sierra, Jorge 1971- (Institut d'Investigació Biomèdica Sant Pau)
Ribera, Jose-Maria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Santarone, Stella (Ospedale Civile)
Benedetto, Bruno (S.S.C.V.D Trapianto di Cellule Staminali A.O.U Citta della Salute e della Scienza di Torino)
Rambaldi, Alessandro (Azienda Ospedaliera Papa Giovanni XXIII)
Saccardi, Riccardo (Azienda Ospedaliera Universitaria Careggi)
Blaise, Didier (Institut Paoli Calmettes)
Carella, Michele Angelo (IRCCS)
Rocha, Vanderson (Universidade de São Paulo)
Baron, Frederic (University of Liege)
Mohty, Mohamad (Hospital Saint- Antoine)
Ruggeri, Annalisa (Ospedale Pediatrico Bambino Gesù (Roma, Itàlia))
Nagler, Arnon (Tel-Aviv University)
Universitat Autònoma de Barcelona

Data:	2018
Resum:	Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established. This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics. SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1. 03, p = 0. 92 or HR = 1. 86, p = 0. 21) and relapse incidence (HR = 0. 8, p = 0. 65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2. 63, p = 0. 001); moreover, SUCBT did worse in terms of overall survival (HR = 2. 18, p = 0. 002), leukemia-free survival (HR = 1. 94, p = 0. 007), and GvHD relapse-free survival (HR = 2. 38, p = 0. 0002). Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Acute myeloid leukemia ; Conditioning regimens ; Haploidentical stem cell transplantation ; Stem cell transplantation ; Thiotepa-busulfan-fludarabine ; Umbilical cord blood transplantation
Publicat a:	Journal of hematology & oncology, Vol. 11 Núm. 1 (30 2018) , p. 110, ISSN 1756-8722

DOI: 10.1186/s13045-018-0655-8
PMID: 30165887

10 p, 786.4 KB

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