RT Journal Article
T1 Post-Transplantation Cyclophosphamide After HLA Identical Compared to Haploidentical Donor Transplant in Acute Myeloid Leukemia: A Study on Behalf of GETH-TC.
A1 Bailen, Rebeca
A1 Pascual-Cascon, Maria Jesus
A1 Guerreiro, Manuel
A1 Lopez-Corral, Lucia
A1 Chinea, Anabelle
A1 Bermudez, Arancha
A1 Sampol, Antonia
A1 Heras, Inmaculada
A1 Garcia-Torres, Estefania
A1 Torres, Melissa
A1 Roca, Jose Rifon
A1 Herruzo, Beatriz
A1 Sanz, Jaime
A1 Fonseca, Marta
A1 Herrera, Pilar
A1 Colorado, Mercedes
A1 Bento, Leyre
A1 Lopez-Godino, Oriana
A1 Martin-Calvo, Carmen
A1 Fernandez-Caldas, Paula
A1 Marcos-Jubilar, Maria
A1 Sanchez-Ortega, Isabel
A1 Solano, Carlos
A1 Noriega, Victor
A1 Humala, Karem
A1 Oarbeascoa, Gillen
A1 Diez-Martin, Jose Luis
A1 Kwon, Mi
K1 Acute myeloid leukemia
K1 GVHD prophylaxis
K1 Post-transplantation cyclophosphamide
AB Post-transplantation cyclophosphamide (PTCY) effectively prevents graft-versus-host disease (GVHD) after unmanipulated HLA-haploidentical hematopoietic stem cell transplantation (HSCT) and achieves low rates of GVHD in HLA-identical transplantation. To compare the outcomes of haploidentical versus HLA identical HSCT in patients undergoing HSCT for acute myeloid leukemia (AML) using PTCY. We conducted a retrospective study of 229 patients undergoing first HSCT for AML using PTCY with additional immunosuppression, 99 from matched sibling or unrelated donor (MSD/MUD) performed in 3 hospitals and 130 from haploidentical donors (haplo group) performed in 20 hospitals within the Spanish Group of Hematopoietic Stem Cell Transplantation and Cellular Therapy. Peripheral blood stem cells were used as graft in 89% of patients; myeloablative conditioning was used in 56%. There were significantly more patients with active disease (5% versus 20%, P = .001), high/very high disease risk index (DRI) (32% versus 67%, P = .000) and prior auto-HSCT (2% versus 11%, P = .010) in the haplo group. Median follow-up was 27 and 62.5 months for MSD/MUD and haplo, respectively. At 2 years, no significant differences were observed in overall survival (OS) (72% versus 62%, P = .07), event-free survival (EFS) (70% versus 54%, P = .055), cumulative incidence of relapse (19% versus 25%, P = .13), non-relapse mortality (14% versus 19%, P = .145), and the composite endpoint of GVHD and relapse-free survival (49% versus 42%, P = .249). Multivariate analysis identified only age and active disease as significant risk factors for OS and EFS; reduced-intensity conditioning, high/very high DRI, and haplo donor were nearly statistically significant for these outcomes. Grade II-IV acute GVHD was lower in MSD/MUD (14% versus 47%, P = .000). Cumulative incidences of grade III-IV acute GVHD (4% versus 9%, P = .14) and moderate-severe chronic GVHD (22% versus 19%, P = .28) were similar. Limitations of our study include limited sample size, differences between haplo and MSD/MUD groups and heterogeneous additional immunosuppression and PTCY timing in MSD/MUD. The use of an HLA-identical donor with PTCY in patients with AML showed lower incidence of clinically significant grade II-IV acute GVHD compared to haplo donors. Further studies with larger sample sizes should be performed to establish a possible benefit of HLA-identical donor on survival. © 2022 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
PB Elsevier
YR 2022
FD 2022-01-21
LK http://hdl.handle.net/10668/22338
UL http://hdl.handle.net/10668/22338
LA en
NO Bailén R, Pascual-Cascón MJ, Guerreiro M, López-Corral L, Chinea A, Bermúdez A, et al. Post-Transplantation Cyclophosphamide After HLA Identical Compared to Haploidentical Donor Transplant in Acute Myeloid Leukemia: A Study on Behalf of GETH-TC. Transplant Cell Ther. 2022 Apr;28(4):204.e1-204.e10
DS RISalud
RD Apr 18, 2025