Purpose:Posttransplant cyclophosphamide (PTCy) is increas-ingly being utilized as a principle GvHD prophylaxis strategy inallogeneic hematopoietic cell transplantation (allo-HCT). A hap-loidentical (haplo) or matched unrelated donor (UD) is a validoption in the absence of a matched related donor.Experimental Design:We compared the outcomes of patientswith acute leukemia who underwent haplo bone marrow (haplo-BM,N¼401) versus UD mobilized peripheral blood stem cells (UD-PB,N¼192) transplantation in the setting of PTCy.Results:The median follow-up duration was 36 months in thehaplo-BM group and 16.6 months in the UD-PB group, respectively(P<0.01). Myeloablative conditioning was used in 64.6% and 42.7%of haplo-BM and UD-PB patients, respectively (P<0.01). Cumu-lative incidence of neutrophil engraftment at day 30 was 87% inhaplo-BM versus 94% in UD-PB, respectively (P¼0.21). In themultivariate analysis, the risk of grade 2–4 acute GvHD (HR¼0.53,P¼0.01) and chronic GvHD (HR¼0.50,P¼0.02) was signif-icantly lower in the haplo-BM group compared with the UD-PBgroup. There was no significant difference between the studygroups with respect to relapse incidence, nonrelapse mortality,leukemia-fee survival, overall survival, or GvHD-free and relapse-free survival.Conclusions:The use of a haplo donor with a BM graft resultedin a lower incidence of GvHD compared with a UD-PB stem cellgraft in the setting of PTCy for patients with acute leukemia.However, differences in GvHD did not translate into a differencein survival outcomes. Based upon these data, UD-PB or haplo-BMshould be considered equally acceptable sources for allo-HCT
Sica, S., comparison of haploidentical bone marrow versus matchet unrelated donor peripheral blood stem cell transplantation with posttransplant cyclophosphamide in patients with acute leukemia, <<CLINICAL CANCER RESEARCH>>, 2021; (27): 843-851 [http://hdl.handle.net/10807/169843]
comparison of haploidentical bone marrow versus matchet unrelated donor peripheral blood stem cell transplantation with posttransplant cyclophosphamide in patients with acute leukemia
Sica, Simona
Membro del Collaboration Group
2021
Abstract
Purpose:Posttransplant cyclophosphamide (PTCy) is increas-ingly being utilized as a principle GvHD prophylaxis strategy inallogeneic hematopoietic cell transplantation (allo-HCT). A hap-loidentical (haplo) or matched unrelated donor (UD) is a validoption in the absence of a matched related donor.Experimental Design:We compared the outcomes of patientswith acute leukemia who underwent haplo bone marrow (haplo-BM,N¼401) versus UD mobilized peripheral blood stem cells (UD-PB,N¼192) transplantation in the setting of PTCy.Results:The median follow-up duration was 36 months in thehaplo-BM group and 16.6 months in the UD-PB group, respectively(P<0.01). Myeloablative conditioning was used in 64.6% and 42.7%of haplo-BM and UD-PB patients, respectively (P<0.01). Cumu-lative incidence of neutrophil engraftment at day 30 was 87% inhaplo-BM versus 94% in UD-PB, respectively (P¼0.21). In themultivariate analysis, the risk of grade 2–4 acute GvHD (HR¼0.53,P¼0.01) and chronic GvHD (HR¼0.50,P¼0.02) was signif-icantly lower in the haplo-BM group compared with the UD-PBgroup. There was no significant difference between the studygroups with respect to relapse incidence, nonrelapse mortality,leukemia-fee survival, overall survival, or GvHD-free and relapse-free survival.Conclusions:The use of a haplo donor with a BM graft resultedin a lower incidence of GvHD compared with a UD-PB stem cellgraft in the setting of PTCy for patients with acute leukemia.However, differences in GvHD did not translate into a differencein survival outcomes. Based upon these data, UD-PB or haplo-BMshould be considered equally acceptable sources for allo-HCTI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.