Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMT
Abstract Background The use of post-transplant cyclophosphamide (PTCy) is highly effective in preventing graft-versus-host disease (GVHD) in the haploidentical (Haplo) transplant setting and is being increasingly used in matched sibling (MSD) and matched unrelated (MUD) transplants. There is no info...
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doaj-c5cf9464d84340149bef06673faa4d2f2020-11-25T03:10:12ZengBMCJournal of Hematology & Oncology1756-87222020-05-0113111310.1186/s13045-020-00882-6Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMTJaime Sanz0Jacques-Emmanuel Galimard1Myriam Labopin2Boris Afanasyev3Emanuele Angelucci4Fabio Ciceri5Didier Blaise6Jan J. Cornelissen7Ellen Meijer8J. L. Diez-Martin9Yener Koc10Montserrat Rovira11Luca Castagna12Bipin Savani13Annalisa Ruggeri14Arnon Nagler15Mohamad Mohty16Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)Hematology Department, Hospital Universitari i Politècnic La FeEBMT Paris Office, Hospital Saint AntoineEBMT Paris Office, Hospital Saint AntoineFirst State Pavlov Medical University of St. Petersburg, Raisa Gorbacheva Memorial Research Institute for Paediatric Oncology, Hematology, and TransplantationDepartment of Haematology, IRCCS Ospedale Policlinico San MartinoHaematology and BMT, Ospedale San Raffaele s.r.l.Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli CalmettesDepartment of Hematology, Erasmus MC Cancer Institute, University Medical Center RotterdamDepartment of Hematology (Br 250), VU University Medical CenterHematology Department, Hospital GU Gregorio Marañon, Instituto de Investigación sanitaria Gregorio Marañon, Universidad Complutense MadridStem Cell Transplant Unit, Medical Park HospitalsDept. of Hematology, Institute of Hematology & Oncology, Hospital ClinicTransplantation Unit, Department of Oncology and Haematology, Istituto Clinico HumanitasVanderbilt University Medical CenterDepartment of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children’s HospitalDivision of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical CenterDepartment of Hematology, Hopital Saint Antoine, Sorbonne UniversityAbstract Background The use of post-transplant cyclophosphamide (PTCy) is highly effective in preventing graft-versus-host disease (GVHD) in the haploidentical (Haplo) transplant setting and is being increasingly used in matched sibling (MSD) and matched unrelated (MUD) transplants. There is no information on the impact of donor types using homogeneous prophylaxis with PTCy. Methods We retrospectively compared outcomes of adult patients with acute myeloid leukemia (AML) in first complete remission (CR1) who received a first allogeneic stem cell transplantation (SCT) with PTCy as GVHD prophylaxis from MSD (n = 215), MUD (n = 235), and Haplo (n = 789) donors registered in the EBMT database between 2010 and 2017. Results The median follow-up was 2 years. Haplo-SCT carried a significantly increased risk of acute grade II–IV GVHD (HR 1.6; 95% CI 1.1–2.4) and NRM (HR 2.6; 95% CI 1.5–4.5) but a lower risk of relapse (HR 0.7; 95% CI 0.5–0.9) that translated to no differences in LFS (HR 1.1; 95% CI 0.8–1.4) or GVHD/relapse-free survival (HR 1; 95% CI 0.8–1.3). Interestingly, the use of peripheral blood was associated with an increased risk of acute (HR 1.9; 95% CI 1.4–2.6) and chronic GVHD (HR 1.7; 95% CI 1.2–2.4) but a lower risk of relapse (HR 0.7; 95% CI 0.5–0.9). Conclusions The use of PTCy in patients with AML in CR1 receiving SCT from MSD, MUD, and Haplo is safe and effective. Haplo-SCT had increased risk of acute GVHD and NRM and lower relapse incidence but no significant difference in survival.http://link.springer.com/article/10.1186/s13045-020-00882-6Post-transplant cyclophosphamideHaploidentical transplantAlternative donor transplantsAcute leukemiaAllogeneic stem cell transplant |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jaime Sanz Jacques-Emmanuel Galimard Myriam Labopin Boris Afanasyev Emanuele Angelucci Fabio Ciceri Didier Blaise Jan J. Cornelissen Ellen Meijer J. L. Diez-Martin Yener Koc Montserrat Rovira Luca Castagna Bipin Savani Annalisa Ruggeri Arnon Nagler Mohamad Mohty Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) |
spellingShingle |
Jaime Sanz Jacques-Emmanuel Galimard Myriam Labopin Boris Afanasyev Emanuele Angelucci Fabio Ciceri Didier Blaise Jan J. Cornelissen Ellen Meijer J. L. Diez-Martin Yener Koc Montserrat Rovira Luca Castagna Bipin Savani Annalisa Ruggeri Arnon Nagler Mohamad Mohty Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMT Journal of Hematology & Oncology Post-transplant cyclophosphamide Haploidentical transplant Alternative donor transplants Acute leukemia Allogeneic stem cell transplant |
author_facet |
Jaime Sanz Jacques-Emmanuel Galimard Myriam Labopin Boris Afanasyev Emanuele Angelucci Fabio Ciceri Didier Blaise Jan J. Cornelissen Ellen Meijer J. L. Diez-Martin Yener Koc Montserrat Rovira Luca Castagna Bipin Savani Annalisa Ruggeri Arnon Nagler Mohamad Mohty Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) |
author_sort |
Jaime Sanz |
title |
Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMT |
title_short |
Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMT |
title_full |
Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMT |
title_fullStr |
Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMT |
title_full_unstemmed |
Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMT |
title_sort |
post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the alwp ebmt |
publisher |
BMC |
series |
Journal of Hematology & Oncology |
issn |
1756-8722 |
publishDate |
2020-05-01 |
description |
Abstract Background The use of post-transplant cyclophosphamide (PTCy) is highly effective in preventing graft-versus-host disease (GVHD) in the haploidentical (Haplo) transplant setting and is being increasingly used in matched sibling (MSD) and matched unrelated (MUD) transplants. There is no information on the impact of donor types using homogeneous prophylaxis with PTCy. Methods We retrospectively compared outcomes of adult patients with acute myeloid leukemia (AML) in first complete remission (CR1) who received a first allogeneic stem cell transplantation (SCT) with PTCy as GVHD prophylaxis from MSD (n = 215), MUD (n = 235), and Haplo (n = 789) donors registered in the EBMT database between 2010 and 2017. Results The median follow-up was 2 years. Haplo-SCT carried a significantly increased risk of acute grade II–IV GVHD (HR 1.6; 95% CI 1.1–2.4) and NRM (HR 2.6; 95% CI 1.5–4.5) but a lower risk of relapse (HR 0.7; 95% CI 0.5–0.9) that translated to no differences in LFS (HR 1.1; 95% CI 0.8–1.4) or GVHD/relapse-free survival (HR 1; 95% CI 0.8–1.3). Interestingly, the use of peripheral blood was associated with an increased risk of acute (HR 1.9; 95% CI 1.4–2.6) and chronic GVHD (HR 1.7; 95% CI 1.2–2.4) but a lower risk of relapse (HR 0.7; 95% CI 0.5–0.9). Conclusions The use of PTCy in patients with AML in CR1 receiving SCT from MSD, MUD, and Haplo is safe and effective. Haplo-SCT had increased risk of acute GVHD and NRM and lower relapse incidence but no significant difference in survival. |
topic |
Post-transplant cyclophosphamide Haploidentical transplant Alternative donor transplants Acute leukemia Allogeneic stem cell transplant |
url |
http://link.springer.com/article/10.1186/s13045-020-00882-6 |
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