Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation

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 addit...

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Autores: Giannotti, Federica, Labopin, Myriam|||0000-0003-4514-4748, Shouval, Roni, Sanz, Jaime|||0000-0001-6934-4619, Arcese, William, Angelucci, Emanuele, Malouf Sierra, Jorge|||0000-0001-5185-520X, Ribera, Jose-Maria|||0000-0003-1042-6024, Santarone, Stella, Benedetto, Bruno, Rambaldi, Alessandro|||0000-0002-3739-7502, Saccardi, Riccardo|||0000-0002-5763-5467, Blaise, Didier|||0000-0002-5684-9447, Carella, Michele Angelo, Rocha, Vanderson, Baron, Frederic|||0000-0002-2944-3812, Mohty, Mohamad|||0000-0002-7264-808X, Ruggeri, Annalisa|||0000-0002-7261-2765, Nagler, Arnon
Formato: artículo
Fecha de publicación:2018
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:286923
Acesso em linha:https://ddd.uab.cat/record/286923
https://dx.doi.org/urn:doi:10.1186/s13045-018-0655-8
Access Level:acceso abierto
Palavra-chave:Acute myeloid leukemia
Conditioning regimens
Haploidentical stem cell transplantation
Stem cell transplantation
Thiotepa-busulfan-fludarabine
Umbilical cord blood transplantation
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spelling Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantationAn EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabineGiannotti, FedericaLabopin, Myriam|||0000-0003-4514-4748Shouval, RoniSanz, Jaime|||0000-0001-6934-4619Arcese, WilliamAngelucci, EmanueleMalouf Sierra, Jorge|||0000-0001-5185-520XRibera, Jose-Maria|||0000-0003-1042-6024Santarone, StellaBenedetto, BrunoRambaldi, Alessandro|||0000-0002-3739-7502Saccardi, Riccardo|||0000-0002-5763-5467Blaise, Didier|||0000-0002-5684-9447Carella, Michele AngeloRocha, VandersonBaron, Frederic|||0000-0002-2944-3812Mohty, Mohamad|||0000-0002-7264-808XRuggeri, Annalisa|||0000-0002-7261-2765Nagler, ArnonAcute myeloid leukemiaConditioning regimensHaploidentical stem cell transplantationStem cell transplantationThiotepa-busulfan-fludarabineUmbilical cord blood transplantationThiotepa-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.Universitat Autònoma de Barcelona 22018-01-0120182018-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/286923https://dx.doi.org/urn:doi:10.1186/s13045-018-0655-8reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest 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.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2869232026-06-06T12:50:31Z
dc.title.none.fl_str_mv 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
title Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation
spellingShingle Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation
Giannotti, Federica
Acute myeloid leukemia
Conditioning regimens
Haploidentical stem cell transplantation
Stem cell transplantation
Thiotepa-busulfan-fludarabine
Umbilical cord blood transplantation
title_short Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation
title_full Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation
title_fullStr Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation
title_full_unstemmed Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation
title_sort Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation
dc.creator.none.fl_str_mv Giannotti, Federica
Labopin, Myriam|||0000-0003-4514-4748
Shouval, Roni
Sanz, Jaime|||0000-0001-6934-4619
Arcese, William
Angelucci, Emanuele
Malouf Sierra, Jorge|||0000-0001-5185-520X
Ribera, Jose-Maria|||0000-0003-1042-6024
Santarone, Stella
Benedetto, Bruno
Rambaldi, Alessandro|||0000-0002-3739-7502
Saccardi, Riccardo|||0000-0002-5763-5467
Blaise, Didier|||0000-0002-5684-9447
Carella, Michele Angelo
Rocha, Vanderson
Baron, Frederic|||0000-0002-2944-3812
Mohty, Mohamad|||0000-0002-7264-808X
Ruggeri, Annalisa|||0000-0002-7261-2765
Nagler, Arnon
author Giannotti, Federica
author_facet Giannotti, Federica
Labopin, Myriam|||0000-0003-4514-4748
Shouval, Roni
Sanz, Jaime|||0000-0001-6934-4619
Arcese, William
Angelucci, Emanuele
Malouf Sierra, Jorge|||0000-0001-5185-520X
Ribera, Jose-Maria|||0000-0003-1042-6024
Santarone, Stella
Benedetto, Bruno
Rambaldi, Alessandro|||0000-0002-3739-7502
Saccardi, Riccardo|||0000-0002-5763-5467
Blaise, Didier|||0000-0002-5684-9447
Carella, Michele Angelo
Rocha, Vanderson
Baron, Frederic|||0000-0002-2944-3812
Mohty, Mohamad|||0000-0002-7264-808X
Ruggeri, Annalisa|||0000-0002-7261-2765
Nagler, Arnon
author_role author
author2 Labopin, Myriam|||0000-0003-4514-4748
Shouval, Roni
Sanz, Jaime|||0000-0001-6934-4619
Arcese, William
Angelucci, Emanuele
Malouf Sierra, Jorge|||0000-0001-5185-520X
Ribera, Jose-Maria|||0000-0003-1042-6024
Santarone, Stella
Benedetto, Bruno
Rambaldi, Alessandro|||0000-0002-3739-7502
Saccardi, Riccardo|||0000-0002-5763-5467
Blaise, Didier|||0000-0002-5684-9447
Carella, Michele Angelo
Rocha, Vanderson
Baron, Frederic|||0000-0002-2944-3812
Mohty, Mohamad|||0000-0002-7264-808X
Ruggeri, Annalisa|||0000-0002-7261-2765
Nagler, Arnon
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Acute myeloid leukemia
Conditioning regimens
Haploidentical stem cell transplantation
Stem cell transplantation
Thiotepa-busulfan-fludarabine
Umbilical cord blood transplantation
topic Acute myeloid leukemia
Conditioning regimens
Haploidentical stem cell transplantation
Stem cell transplantation
Thiotepa-busulfan-fludarabine
Umbilical cord blood transplantation
description 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.
publishDate 2018
dc.date.none.fl_str_mv 2
2018-01-01
2018
2018-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/286923
https://dx.doi.org/urn:doi:10.1186/s13045-018-0655-8
url https://ddd.uab.cat/record/286923
https://dx.doi.org/urn:doi:10.1186/s13045-018-0655-8
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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