Haploidentical vs. sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia

The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remissio...

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Detalhes bibliográficos
Autores: Wieduwilt, Matthew J., Metheny, Leland, Zhang, Mei-Jie, Wang, Hai-Lin, Estrada Merly, Noel, Marks, David I., Al-Homsi, A. Samer, Muffly, Lori, Chao, Nelson J., Rizzieri, David, Gale, Robert Peter, Gadalla, Shahinaz M., Cairo, Mitchell S., Mussetti, Alberto, Gore, Steven D., Bhatt, Vijaya Raj, Patel, Sagar S., Michelis, Fotios V., Inamoto, Yoshihiro, Badawy, Sherif M., Copelan, Edward, Palmisiano, Neil, Kharfan Dabaja, Mohamed A., Lazarus, Hillard M., Ganguly, Siddhartha, Bredeson, Christopher N., Diaz Perez, Miguel Angel, Cassaday, Ryan, Savani, Bipin N., Kuhn Ballen, Karen, Martino, Rodrigo, Wirk, Baldeep, Bacher, Ulrike, Aljurf, Mahmoud, Bashey, Asad, Murthy, Hemant S., Yared, Jean A., Aldoss, Ibrahim, Farhadfar, Nosha, Liu, Hongtao, Abdel Azim, Hisham, Waller, Edmund K., Solh, Melhem, Seftel, Matthew, Van Der Poel, Marjolein W.M., Grunwald, Michael Richard, Liesveld, Jane L., Kamble, Rammurti T., Mcguirk, Joseph P., Munker, Reinhold, Cahn, Jean-Yves, Wook Lee, Jong, Freytes, Cesar O., Krem, Maxwell, Winestone, Lena E., Gergis, Usama, Nathan, Sunita, Olsson, Richard F., Verdonck, Leo F., Sharma, Akshay, Ringden, Olle, Friend, Brian D., Cerny, Jan, Choe, Hannah K., Chhabra, Saurabh, Nishihori, Taiga, Seo, Sachiko, George, Biju, Baxter Lowe, Lee Ann, Hildebrandt, Gerhard C., Lima, Marcos de, Litzow, Mark R., Kebriaei, Partow, Hourigan, Christopher S., Bilal Abid, Muhammad, Weisdorf, Daniel J., Saber, Wael
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/183782
Acesso em linha:https://hdl.handle.net/2445/183782
Access Level:acceso abierto
Palavra-chave:Leucèmia aguda
Cèl·lules mare
Sang fetal
Acute leukemia
Stem cells
Fetal blood
Descrição
Resumo:The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLAmatched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P <_ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P <_ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (<_18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

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