140 results on '"Gerard Socié"'
Search Results
2. CNS Involvement at Initial Diagnosis and Risk of Relapse After Allogeneic HCT for Acute Lymphoblastic Leukemia in First Complete Remission
- Author
-
Mohamed A. Kharfan-Dabaja, Myriam Labopin, Ali Bazarbachi, Urpu Salmenniemi, Stephan Mielke, Patrice Chevallier, Marie Thérèse Rubio, Marie Balsat, Pietro Pioltelli, Anne-Lise Menard, Gerard Socié, Anne Huynh, Nicolaas Schaap, Arancha Bermúdez Rodríguez, Jan J. Cornelissen, Ibrahim Yakoub-Agha, Mahmoud Aljurf, Sebastian Giebel, Eolia Brissot, Zina Peric, Arnon Nagler, and Mohamad Mohty
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Outcomes of allogeneic hematopoietic cell transplantation (allo-HCT) for adult acute lymphoblastic leukemia (ALL) have improved over time. Studies have shown that total body irradiation (TBI) is the preferable type of myeloablative conditioning (MAC). However, outcomes based on central nervous system (CNS) involvement, namely CNS-positive versus CNS-negative, have not been compared. Here, we evaluated outcomes of 547 patients (CNS-positive = 96, CNS-negative = 451) who were allografted in the first complete remission (CR1) between 2009 and 2019. Primary endpoint was leukemia-free survival (LFS). Median follow-up was not different between the CNS-positive and CNS-negative groups (79 versus 67.2 months, P = 0.58). The CNS-positive group were younger (median age 31.3 versus 39.7 years, P = 0.004) and were allografted more recently (median year 2012 versus 2010, P = 0.003). In both groups, MAC was the preferred approach (82.3% versus 85.6%, P = 0.41). On multivariate analysis, the CNS-positive group had higher incidence of relapse (RI) (hazard ratio [HR] = 1.58 [95% confidence interval (CI) = 1.06-2.35], P = 0.025), but no adverse effect on LFS (HR = 1.38 [95% CI = 0.99-1.92], P = 0.057) or overall survival (OS) (HR = 1.28 [95% CI = 0.89-1.85], P = 0.18). A subgroup multivariate analysis limited to CNS-positive patients showed that a TBI-based MAC regimen resulted in better LFS (HR = 0.43 [95% CI = 0.22-0.83], P = 0.01) and OS (HR = 0.44 [95% CI = 0.21-0.92], P = 0.03) and lower RI (HR = 0.35 [95% CI = 0.15-0.79], P = 0.01). Another subgroup analysis in CNS-negative patients showed that MAC-TBI preparative regimens also showed a lower RI without a benefit in LFS or OS. While a MAC-TBI allo-HCT regimen may not be suitable to all, particularly for older patients with comorbidities, this approach should be considered for patients who are deemed fit and able to tolerate.
- Published
- 2022
- Full Text
- View/download PDF
3. Measurable residual disease status and outcome of transplant in acute myeloid leukemia in second complete remission: a study by the acute leukemia working party of the EBMT
- Author
-
Maria H. Gilleece, Avichai Shimoni, Myriam Labopin, Stephen Robinson, Dietrich Beelen, Gerard Socié, Ali Unal, Arnold Ganser, Antonin Vitek, Henrik Sengeloev, Ibrahim Yakoub-Agha, Eleni Tholouli, Emmanuelle Polge, Mohamad Mohty, and Arnon Nagler
- Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Measurable residual disease (MRD) prior to hematopoietic cell transplant (HCT) for acute myeloid leukemia (AML) in first complete morphological remission (CR1) is an independent predictor of outcome, but few studies address CR2. This analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation registry assessed HCT outcomes by declared MRD status in a cohort of 1042 adult patients with AML CR2 at HCT. Patients were transplanted 2006–2016 from human leukocyte antigen (HLA) matched siblings (n = 719) or HLA 10/10 matched unrelated donors (n = 293). Conditioning was myeloablative (n = 610) or reduced-intensity (n = 432) and 566 patients (54%) had in-vivo T cell depletion. At HCT, 749 patients (72%) were MRD negative (MRD NEG) and 293 (28%) were MRD positive (MRD POS). Time from diagnosis to HCT was longer in MRD NEG than MRD POS patients (18 vs. 16 months (P
- Published
- 2021
- Full Text
- View/download PDF
4. Integrating biological HLA-DPB1 mismatch models to predict survival after unrelated hematopoietic cell transplantation
- Author
-
Annalisa Ruggeri, Liesbeth C. de Wreede, Carlheinz R. Müller, Pietro Crivello, Edouard F. Bonneville, Effie W. Petersdorf, Gerard Socié, Valérie Dubois, Riitta Niittyvuopio, Juha Peräsaari, Ibrahim Yakoub-Agha, Jan J. Cornelissen, Lotte Wieten, Tobias Gedde-Dahl, Edouard Forcade, Charles R. Crawley, Steven G.E. Marsh, Virginie Gandemer, Eleni Tholouli, Claude-Eric Bulabois, Anne Huynh, Goda Choi, Eric Deconinck, Maija Itäla-Remes, Stig Lenhoff, Mats Bengtsson, Jan-Erik Johansson, Gwendolyn van Gorkom, Jorinde D. Hoogenboom, Luca Vago, Vanderson Rocha, Chiara Bonini, Christian Chabannon, and Katharina Fleischhauer
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2022
- Full Text
- View/download PDF
5. The EHA Research Roadmap: Hematopoietic Stem Cells and Allotransplantation
- Author
-
Willem Fibbe, Rosa Bernardi, Pierre Charbord, Daniela Krause, Cristina Lo Celso, Simón Méndez-Ferrer, Christine Mummery, Robert Oostendorp, Marc Raaijmakers, Gerard Socié, Frank Staal, and Andrea Bacigalupo
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2022
- Full Text
- View/download PDF
6. Measurable residual disease at myeloablative allogeneic transplantation in adults with acute lymphoblastic leukemia: a retrospective registry study on 2780 patients from the acute leukemia working party of the EBMT
- Author
-
Jiří Pavlů, Myriam Labopin, Riitta Niittyvuopio, Gerard Socié, Ibrahim Yakoub-Agha, Depei Wu, Peter Remenyi, Jakob Passweg, Dietrich W. Beelen, Mahmoud Aljurf, Nicolaus Kröger, Hélène Labussière-Wallet, Zinaida Perić, Sebastian Giebel, Arnon Nagler, and Mohamad Mohty
- Subjects
Measurable residual disease ,Allogeneic hematopoietic cell transplantation ,Acute lymphoblastic leukemia ,Allogeneic ,Myeloablative conditioning ,Total body irradiation ,Diseases of the blood and blood-forming organs ,RC633-647.5 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Assessment of measurable residual disease (MRD) is rapidly transforming the therapeutic and prognostic landscape of a wide range of hematological malignancies. Its prognostic value in acute lymphoblastic leukemia (ALL) has been established and MRD measured at the end of induction is increasingly used to guide further therapy. Although MRD detectable immediately before allogeneic hematopoietic cell transplantation (HCT) is known to be associated with poor outcomes, it is unclear if or to what extent this differs with different types of conditioning. Methods In this retrospective registry study, we explored whether measurable residual disease (MRD) before allogeneic hematopoietic cell transplantation (HCT) for acute lymphoblastic leukemia is associated with different outcomes in recipients of myeloablative total body irradiation (TBI)-based versus chemotherapy-based conditioning. We analyzed outcomes of 2780 patients (median age 38 years, range 18–72) who underwent first HCT in complete remission between 2000 and 2017 using sibling or unrelated donors. Results In 1816 of patients, no disease was detectable, and in 964 patients, MRD was positive. Conditioning was TBI-based in 2122 (76%) transplants. In the whole cohort MRD positivity was a significant independent factor for lower overall survival (OS) and leukemia-free survival (LFS), and for higher relapse incidence (RI), with respective hazard ratios (HR, 95% confidence intervals) of 1.19 (1.02–1.39), 1.26 (1.1–1.44), and 1.51 (1.26–1.8). TBI was associated with a higher OS, LFS, and lower RI with HR of 0.75 (0.62–0.90), 0.70 (0.60–0.82), and 0.60 (0.49–0.74), respectively. No significant interaction was found between MRD status and conditioning. When investigating the impact of MRD separately in the TBI and chemotherapy-based conditioning cohorts by multivariate analysis, we found MRD positivity to be associated with lower OS and LFS and higher RI in the TBI group, and with higher RI in the chemotherapy group. TBI-based conditioning was associated with improved outcomes in both MRD-negative and MRD-positive patients. Conclusions In this large study, we confirmed that patients who are MRD-negative prior to HCT achieve superior outcomes. This is particularly apparent if TBI conditioning is used. All patients with ALL irrespective of MRD status benefit from TBI-based conditioning in the myeloablative setting.
- Published
- 2019
- Full Text
- View/download PDF
7. Association of Country-Specific Socioeconomic Factors With Survival of Patients Who Experience Severe Classic Acute Graft-vs.-Host Disease After Allogeneic Hematopoietic Cell Transplantation. An Analysis From the Transplant Complications Working Party of the EBMT
- Author
-
Andrzej Frankiewicz, Christophe Peczynski, Sebastian Giebel, Alenca Harrington, Gerard Socié, Dietger Niederwieser, Christoph Scheid, Martin Bornhäuser, Nicolaus Kröger, Ahmet Elmaagacli, Boris Afanasyev, Peter Dreger, Claudia Rössig, Didier Blaise, Christian Kratz, Ibrahim Yakoub-Agha, Bernhard Kremens, Charlotte Marie Niemeyer, Gerald Wulf, Igor Blau, Olaf Penack, Hildegard Greinix, and Grzegorz W. Basak
- Subjects
health care expenditure ,human development index ,hematopoietic cell transplantation ,acute graft-vs.-host disease ,transplant-related mortality ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Acute graft-vs.-host disease (aGvHD) is one of the most frequent causes of transplant-related mortality (TRM) after allogeneic hematopoietic cell transplantation (alloHCT). Its treatment is complex and costly. The aim of this study was to retrospectively analyze the impact of country-specific socioeconomic factors on outcome of patients who experience severe aGvHD. Adults with hematological malignancies receiving alloHCT from either HLA-matched siblings (n = 1,328) or unrelated donors (n = 2,824) developing grade 3 or 4 aGvHD were included. In univariate analysis, the probability of TRM at 2 years was increased for countries with lower current Health Care Expenditure (HCE, p = 0.04), lower HCE as % of Gross Domestic Product per capita (p = 0.003) and lower values of the Human Development Index (p = 0.02). In a multivariate model, the risk of TRM was most strongly predicted by current HCE (HR = 0.76, p = 0.006). HCE >median was also associated with reduced risk of the overall mortality (HR 0.73, p = 0.0006) and reduced risk of treatment failure (either relapse or TRM; HR 0.77, p = 0.004). We conclude that country-specific socioeconomic factors, in particular current HCE, are strongly associated with survival of patients who experience severe aGvHD.
- Published
- 2020
- Full Text
- View/download PDF
8. Allogeneic stem cell transplantation in second complete remission for core binding factor acute myeloid leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
- Author
-
Kazimierz Halaburda, Myriam Labopin, Audrey Mailhol, Gerard Socié, Charles Craddock, Mahmoud Aljurf, Dietrich Beelen, Jan J. Cornelissen, Jean-Henri Bourhis, Hélène Labussière-Wallet, Didier Blaise, Tobias Gedde-Dahl, Maria Gilleece, Ibrahim Yakoub-Agha, Ghulam Mufti, Jordi Esteve, Mohamad Mohty, and Arnon Nagler
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Core binding factor acute myeloid leukemia (AML) comprises two subtypes with distinct cytogenetic abnormalities of either t(8;21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22). Since long-term response to chemotherapy in these leukemias is relatively good, allogeneic hematopoietic stem cell transplantation is considered in patients who relapse and achieve second complete remission. To evaluate the outcomes of allogeneic transplantation in this indication, we studied 631 patients reported to the European Society for Blood and Marrow Transplantation Registry between the years 2000 and 2014. Leukemia-free survival probabilities at two and five years were 59.1% and 54.1%, while overall survival probabilities were 65% and 58.2%, respectively. The incidence of relapse and risk of non-relapse mortality at the same time points were 19.8% and 22.5% for relapse and 20.9% and 23.3% for non-relapse mortality, respectively. The most important adverse factors influencing leukemia-free and overall survival were: leukemia with t(8;21), presence of three or more additional chromosomal abnormalities, and Karnofsky performance score
- Published
- 2020
- Full Text
- View/download PDF
9. Sorafenib improves survival of FLT3-mutated acute myeloid leukemia in relapse after allogeneic stem cell transplantation: a report of the EBMT Acute Leukemia Working Party
- Author
-
Ali Bazarbachi, Myriam Labopin, Giorgia Battipaglia, Azedine Djabali, Jakob Passweg, Gerard Socié, Edouard Forcade, Didier Blaise, Patrice Chevallier, Corentin Orvain, Jan J. Cornelissen, William Arcese, Sylvain Chantepie, Khowla Hashaishi, Jean El Cheikh, Michael Medinger, Jordi Esteve, Arnon Nagler, and Mohamad Mohty
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2019
- Full Text
- View/download PDF
10. Stem cell transplantation for congenital dyserythropoietic anemia: an analysis from the European Society for Blood and Marrow Transplantation
- Author
-
Maurizio Miano, Dirk-Jan Eikema, Mahmoud Aljurf, Pieter J. van’t Veer, Gülyüz Öztürk, Matthias Wölfl, Frans Smiers, Angsar Schulz, Gerard Socié, Kim Vettenranta, Cristina Diaz de Heredia, Marco Zecca, Johan Maertens, Montserrat Rovira, Jorge Sierra, Duygu Uckan-Cetinkaya, Elena Skorobogatova, Ali Bülent Antmen, Jean-Hugues Dalle, Miroslaw Markiewicz, Rose Marie Hamladji, Vassiliki Kitra-Roussou, Giorgio La Nasa, Gergely Kriván, Amal Al-Seiraihy, Stefano Giardino, Antonio Maria Risitano, Regis Peffault de Latour, and Carlo Dufour
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2019
- Full Text
- View/download PDF
11. Allogeneic Stem Cell Transplantation for FLT3-Mutated Acute Myeloid Leukemia: In vivo T-Cell Depletion and Posttransplant Sorafenib Maintenance Improve Survival. A Retrospective Acute Leukemia Working Party-European Society for Blood and Marrow Transplant Study
- Author
-
Ali Bazarbachi, Myriam Labopin, Giorgia Battipaglia, Azedine Djabali, Edouard Forcade, William Arcese, Gerard Socié, Didier Blaise, Joerg Halter, Sabine Gerull, Jan J. Cornelissen, Patrice Chevallier, Johan Maertens, Nicolaas Schaap, Jean El-Cheikh, Jordi Esteve, Arnon Nagler, and Mohamad Mohty
- Subjects
Allogeneic stem cell transplantation ,Acute myeloid leukemia ,FLT3 mutation ,In vivo T-cell depletion ,Sorafenib ,Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Acute myeloid leukemia (AML) with FLT3-mutation carries a poor prognosis, and allogeneic stem cell transplantation (allo-SCT) is recommended at first complete remission (CR1). We assessed 462 adults (median age 50 years) with FLT3-mutated AML allografted between 2010 and 2015 from a matched related (40%), unrelated (49%), or haploidentical donor (11%). The median follow-up of alive patients was 39 months. Day-100 acute graft versus host disease (GVHD) grades II–IV and III–IV were encountered in 26% and 9%, whereas the 2-year incidence of chronic and extensive chronic GVHD were 34% and 16%, respectively. The 2-year incidences of relapse and nonrelapse mortality were 34% and 15%, respectively. The 2-year leukemia-free survival, overall survival (OS), and GVHD relapse-free survival (GRFS) were 51%, 59%, and 38%, respectively. In multivariate analysis, NPM1-mutation, transplantation in CR1, in vivo T-cell depletion, and posttransplant sorafenib improved OS, whereas more than one induction (late CR1) negatively affected OS. Similarly, NPM1-mutation, a haploidentical donor, T-cell depletion, and sorafenib maintenance improved GRFS, whereas late CR1 or persistent disease negatively affected it. In conclusion, FLT3-mutated AML remains a challenge even following allo-SCT. In vivo T-cell depletion and posttransplant sorafenib significantly improve OS and GRFS, and may be considered as standard of care.
- Published
- 2019
- Full Text
- View/download PDF
12. Aplastic anemia in the elderly: a nationwide survey on behalf of the French Reference Center for Aplastic Anemia
- Author
-
Adrien Contejean, Matthieu Resche-Rigon, Jérôme Tamburini, Marion Alcantara, Fabrice Jardin, Etienne Lengliné, Lionel Adès, Didier Bouscary, Ambroise Marçais, Delphine Lebon, Cécile Chabrot, Louis Terriou, Fiorenza Barraco, Anne Banos, Lucile Bussot, Jean-Yves Cahn, Pierre Hirsch, Natacha Maillard, Laurence Simon, Luc-Matthieu Fornecker, Gerard Socié, Regis Peffault de Latour, and Flore Sicre de Fontbrune
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Aplastic anemia is a rare but potentially life-threatening disease that may affect older patients. Data regarding the treatment of aplastic anemia in this ageing population remains scarce. We conducted a retrospective nationwide multicenter study in France to examine current treatments for aplastic anemia patients over 60 years old. Our aims were to evaluate efficacy and tolerance, and to analyze predictive factors for response and survival. Over the course of a decade, 88 patients (median age 68.5 years) were identified in 19 centers, with a median follow up of 2.7 years; 21% had very severe and 36% severe aplastic anemia. We analyzed 184 treatment lines, mostly involving the standard combination of anti-thymocyte globulin and cyclosporine-A (33%), which was also the most frequent first-line treatment (50%). After first-line therapy, 32% of patients achieved a complete response, and 15% a partial response. Responses were significantly better in first line and in patients with good performance status, as well as in those that had followed an anti-thymocyte globulin and cyclosporine-A regimen (overall response rate of 70% after first-line treatment). All treatments were well tolerated by patients, including over the age of 70. Three-year survival was 74.7% (median 7.36 years). Age, Charlson comorbidity index and very severe aplastic anemia were independently associated with mortality. Age, per se, is not a limiting factor to aplastic anemia treatment with anti-thymocyte globulin and cyclosporine-A; this regimen should be used as a first-line treatment in elderly patients if they have a good performance status and low comorbidity index score.
- Published
- 2019
- Full Text
- View/download PDF
13. Nationwide survey on the use of eltrombopag in patients with severe aplastic anemia: a report on behalf of the French Reference Center for Aplastic Anemia
- Author
-
Etienne Lengline, Bernard Drenou, Pierre Peterlin, Olivier Tournilhac, Julie Abraham, Ana Berceanu, Brigitte Dupriez, Gaelle Guillerm, Emmanuel Raffoux, Flore Sicre de Fontbrune, Lionel Ades, Marie Balsat, Driss Chaoui, Paul Coppo, Selim Corm, Thierry Leblanc, Natacha Maillard, Louis Terriou, Gerard Socié, and Regis Peffault de Latour
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Few therapeutic options are available for patients with aplastic anemia who are ineligible for transplantation or refractory to immunosuppressive therapy. Eltrombopag was recently shown to produce trilineage responses in refractory patients. However, the effects of real-life use of this drug remain unknown. This retrospective study (2012–2016) was conducted by the French Reference Center for Aplastic Anemia on patients with relapsed/refractory aplastic anemia, and patients ineligible for antithymocyte globulin or transplantation, who received eltrombopag for at least 2 months. Forty-six patients with aplastic anemia were given eltrombopag without prior antithymocyte globulin treatment (n=11) or after antithymocyte globulin administration (n=35) in a relapsed/refractory setting. Eltrombopag (median daily dose 150 mg) was introduced 17 months (range, 8–50) after the diagnosis of aplastic anemia. At last followup, 49% were still receiving treatment, 9% had stopped due to a robust response, 2% due to toxicity and 40% due to eltrombopag failure. Before eltrombopag treatment, all patients received regular transfusions. The overall rates of red blood cell and platelet transfusion independence were 7%, 33%, 46% and 46% at 1, 3, 6 months and last follow-up. Responses were slower to develop in antithymocyte treatment-naïve patients. In patients achieving transfusion independence, hemoglobin concentration and platelet counts improved by 3 g/dL (interquartile range, 1.4–4.5) and 42×109/L (interquartile range, 11–100), respectively. Response in at least one lineage (according to National Institutes of Health criteria) was observed in 64% of antithymocyte treatment-naïve and 74% of relapsed/refractory patients, while trilineage improvement was observed in 27% and 34%, respectively. We found high rates of hematologic improvement and transfusion independence in refractory aplastic anemia patients but also in patients ineligible for antithymocyte globulin receiving first-line treatment. In conclusion, elderly patients unfit for antithymocyte globulin therapy may benefit from eltrombopag.
- Published
- 2018
- Full Text
- View/download PDF
14. Improving results of allogeneic hematopoietic cell transplantation for adults with acute lymphoblastic leukemia in first complete remission: an analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
- Author
-
Sebastian Giebel, Myriam Labopin, Gerard Socié, Dietrich Beelen, Paul Browne, Liisa Volin, Slawomira Kyrcz-Krzemien, Ibrahim Yakoub-Agha, Mahmoud Aljurf, Depei Wu, Mauricette Michallet, Renate Arnold, Mohamad Mohty, and Arnon Nagler
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Allogeneic hematopoietic cell transplantation is widely used to treat adults with high-risk acute lymphoblastic leukemia. The aim of this study was to analyze whether the results changed over time and to identify prognostic factors. Adult patients treated between 1993 and 2012 with myeloablative allogeneic hematopoietic cell transplantation from HLA matched sibling (n=2681) or unrelated (n=2178) donors in first complete remission were included. For transplantations from sibling donors performed between 2008 and 2012, 2-year probabilities of overall survival were: 76% (18–25 years old), 69% (26–35 and 36–45 years old) and 60% (46–55 years old). Among recipients of transplantations from unrelated donors, the respective survival rates were 66%, 70%, 61%, and 62%. In comparison with the 1993–2007 period, significant improvements were observed for all age groups except for the 26–35-year old patients. In a multivariate model, transplantations performed between 2008 and 2012, when compared to 1993–2007, were associated with significantly reduced risks of non-relapse mortality (Hazard Ratio 0.77, P=0.00006), relapse (Hazard Ratio 0.85, P=0.007), treatment failure (Hazard Ratio 0.81, P
- Published
- 2017
- Full Text
- View/download PDF
15. Allogeneic hematopoietic stem cell transplantation after reduced intensity conditioning regimen for elderly patients (60 years and older) with hematologic malignancies using unrelated donors: a retrospective study from the French society for stem cell transplantation (SFGM-TC)
- Author
-
Jean El Cheikh, Patrick Sfumato, Mohamad Sobh, Nathalie Fegueux, Mohamad Mohty, Stephane Vigouroux, Yves Beguin, Ibrahim Yakoub-Agha, Gerard Socié, Jerome Cornillon, Melanie Mercier, Jacques Olivier Bay, Didier Blaise, Mauricette Michallet, and Regis Peffault de Latour
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2016
- Full Text
- View/download PDF
16. Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT
- Author
-
Bipin N. Savani, Myriam Labopin, Nicolaus Kröger, Jürgen Finke, Gerhard Ehninger, Dietger Niederwieser, Rainer Schwerdtfeger, Donald Bunjes, Bertram Glass, Gerard Socié, Per Ljungman, Charles Craddock, Frédéric Baron, Fabio Ciceri, Norbert Claude Gorin, Jordi Esteve, Christoph Schmid, Sebastian Giebel, Mohamad Mohty, and Arnon Nagler
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
The outcome of patients undergoing HLA-matched unrelated donor allogeneic hematopoietic cell transplantation following reduced-intensity conditioning or myeloablative regimens is reported to be equivalent; however, it is not known if the intensity of the conditioning impacts outcomes after mismatched unrelated donor transplantation for acute myeloid leukemia. Eight hundred and eighty three patients receiving reduced-intensity conditioning were compared with 1041 myeloablative conditioning regimen recipients in the setting of mismatched unrelated donor transplantation. The donor graft was HLA-matched at 9/10 in 872 (83.8%) and at 8/10 in 169 (16.2%) myeloablative conditioning recipients, while in the reduced-intensity conditioning cohort, 754 (85.4%) and 129 (14.6%) were matched at 9/10 and 8/10 loci, respectively. Myeloablative conditioning regimen recipients were younger, 70% being
- Published
- 2016
- Full Text
- View/download PDF
17. The impact of graft-versus-host disease prophylaxis in reduced-intensity conditioning allogeneic stem cell transplant in acute myeloid leukemia: a study from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation
- Author
-
Marie Thérèse Rubio, Myriam Labopin, Didier Blaise, Gerard Socié, Rafael Rojas Contreras, Patrice Chevallier, Miguel A. Sanz, Stéphane Vigouroux, Anne Huynh, Avichai Shimoni, Claude-Eric Bulabois, Nerea Caminos, Lucía López-Corral, Arnon Nagler, and Mohamad Mohty
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
The impact of the intensity of graft-versus-host-disease immunoprophylaxis on transplantation outcomes in patients undergoing transplantation following reduced-intensity conditioning is unclear. This study addresses this issue in 228 adult patients above 50 years of age with acute myeloid leukemia in first complete remission given peripheral blood stem cells from HLA-identical siblings after fludarabine and 2 days of intravenous busulfan reduced-intensity conditioning. A total of 152 patients received anti-thymocyte globulin, either in combination with cyclosporine A in 86 patients (group 1), or with cyclosporine A and mycophenolate mofetil or short course methotrexate in 66 patients (group 2). The remaining 76 patients did not receive anti-thymocyte globulin but were given cyclosporine A and methotrexate or mycophenolate mofetil (group 3). Incidences of grade II-IV acute graft-versus-host-disease were comparable in the three groups (16.5%, 29.5% and 19.5% in groups 1, 2 and 3, respectively, P=0.15). In multivariate analysis, the absence of anti-thymocyte globulin was the only factor associated with a higher risk of chronic graft-versus-host-disease (P=0.005), while the use of triple immunosuppression (group 3) was associated with an increased risk of relapse (P=0.003). In comparison to anti-thymocyte globulin and cyclosporine A alone, the other two strategies of graft-versus-host-disease prophylaxis were associated with reduced leukemia-free survival and overall survival (P=0.001 for each parameter), independently of the dose of anti-thymocyte globulin. These data suggest that fine tuning of the intensity of this prophylaxis can affect the outcome of transplantation and that anti-thymocyte globulin and cyclosporine A alone should be the preferred combination with the fludarabine-busulfan reduced-intensity conditioning regimen and sibling donors.
- Published
- 2015
- Full Text
- View/download PDF
18. Current outcome of HLA identical sibling versus unrelated donor transplants in severe aplastic anemia: an EBMT analysis
- Author
-
Andrea Bacigalupo, Gerard Socié, Rose Marie Hamladji, Mahmoud Aljurf, Alexei Maschan, Slawomira Kyrcz-Krzemien, Alicja Cybicka, Henrik Sengelov, Ali Unal, Dietrich Beelen, Anna Locasciulli, Carlo Dufour, Jakob R. Passweg, Rosi Oneto, Alessio Signori, Judith C.W. Marsh, and for the Aplastic Anemia Working Party of the European Group for Blood Marrow Transplantation (WPSAA-EBMT)
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
We have analyzed 1448 patients with acquired aplastic anemia grafted between 2005 and 2009, and compared outcome of identical sibling (n=940) versus unrelated donor (n=508) transplants. When compared to the latter, sibling transplants were less likely to be performed beyond 180 days from diagnosis (39% vs. 85%), to have a cytomegalovirus negative donor/recipient status (15% vs. 23%), to receive antithymocyte globulin in the conditioning (52% vs. 61%), and more frequently received marrow as a stem cell source (60% vs. 52%). Unrelated donor grafts had significantly more acute grade II–IV (25% vs. 13%) and significantly more chronic graft-versus-host disease (26% vs. 14%). In multivariate analysis, the risk of death of unrelated donor grafts was higher, but not significantly higher, compared to a sibling donor (P=0.16). The strongest negative predictor of survival was the use of peripheral blood as a stem cell source (P
- Published
- 2015
- Full Text
- View/download PDF
19. Outcome of aplastic anemia in adolescence: a survey of the Severe Aplastic Anemia Working Party of the European Group for Blood and Marrow Transplantation
- Author
-
Carlo Dufour, Marta Pillon, Jakob Passweg, Gerard Socié, Andrea Bacigalupo, Genny Franceschetto, Elisa Carraro, Rosi Oneto, Antonio Maria Risitano, Regis Peffault de Latour, André Tichelli, Alicia Rovo, Christina Peters, Britta Hoechsmann, Sujith Samarasinghe, Austin G Kulasekararaj, Hubert Schrezenmeier, Mahmoud Aljurf, and Judith Marsh
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
We analyzed the outcome of 537 adolescents (age 12–18 years) with idiopathic aplastic anemia included in the database of the Severe Aplastic Anemia Working Party of the European Group for Blood and Marrow Transplantation comparing: i) matched family donor hematopoietic stem cell transplantation performed as first-line treatment with ii) front-line immunosuppressive therapy not followed by subsequent transplant given for failure and with iii) hematopoietic stem cell transplantation performed after failed front-line immunosuppressive therapy. Overall survival was 86% in the matched family donor hematopoietic stem cell transplantation group, 90% in patients given front-line immunosuppressive alone (those who did not fail this treatment and who did not receive subsequent rescue with hematopoietic stem cell transplantation) and 78% in subjects who underwent hematopoietic stem cell transplantation post failed front-line immunosuppressive therapy (P=0.14). Event-free survival in the same groups was respectively 83%, 64% and 71% (P=0.04). Cumulative incidence of rejection was 8% in matched family donor hematopoietic stem cell transplantation and 9% in transplants post failed front-line immunosuppression (P=0.62). Cumulative incidence of acute graft-versus-host disease was 12% in matched family donor transplants and 18% in transplants post failed immunosuppression (P=0.18). Chronic graft-versus-host disease was higher in matched family donor hematopoietic stem cell transplantation (8%) than in transplants post failed immunosuppressive therapy (20%) (P=0.0009). Cumulative incidence of post-therapy malignancies was 0.7% in matched family donor transplantations, 7% in transplantations post failed immunosuppression and 21% after front-line immunosuppression (P=0.0017). In the whole cohort, under multivariate analysis, the diagnosis to treatment interval of two months or under positively affected overall survival whereas up-front immunosuppression alone (with no subsequent rescue transplants) negatively affected event-free survival. In transplanted patients an interval from diagnosis to treatment of 2 months or under, bone marrow as source of cells and first-line matched family donor transplants provided a significant advantage in overall and event-free survival. Aplastic anemia in adolescents has a very good outcome. If a matched family donor is available, hematopoietic stem cell transplantation using bone marrow cells is the first choice treatment. If such a donor is not available, immunosuppressive treatment may still be an acceptable second choice, also because, in case of failure, hematopoietic stem cell transplantation is a very good rescue option.
- Published
- 2014
- Full Text
- View/download PDF
20. Disease severity in chronic graft-versus-host disease: doctors’ gut feeling versus biostatistics?
- Author
-
Gerard Socié
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2014
- Full Text
- View/download PDF
21. Cost-effectiveness and clinical outcomes of double versus single cord blood transplantation in adults with acute leukemia in France
- Author
-
Myriam Labopin, Annalisa Ruggeri, Norbert Claude Gorin, Eliane Gluckman, Didier Blaise, Lionel Mannone, Noel Milpied, Ibrahim Yakoub-Agha, Eric Deconinck, Mauricette Michallet, Nathalie Fegueux, Gerard Socié, Stephanie Nguyen, Jean Yves Cahn, Thierry de Revel, Federico Garnier, Catherine Faucher, Namik Taright, Chantal Kenzey, Fernanda Volt, Dominique Bertrand, Mohamad Mohty, and Vanderson Rocha
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Double cord blood transplantation extends the use of cord blood to adults for whom a single unit is not available, but the procedure is limited by its cost. To evaluate outcomes and cost-effectiveness of double compared to single cord blood transplantation, we analyzed 134 transplants in adults with acute leukemia in first remission. Transplants were performed in France with reduced intensity or myeloablative conditioning regimens. Costs were estimated from donor search to 1 year after transplantation. A Markov decision analysis model was used to calculate quality-adjusted life-years and cost-effectiveness ratio within 4 years. The overall survival at 2 years after single and double cord blood transplants was 42% versus 62%, respectively (P=0.03), while the leukemia-free-survival was 33% versus 53%, respectively (P=0.03). The relapse rate was 21% after double transplants and 42% after a single transplant (P=0.006). No difference was observed for non-relapse mortality or chronic graft-versus-host-disease. The estimated costs up to 1 year after reduced intensity conditioning for single and double cord blood transplantation were € 165,253 and €191,827, respectively. The corresponding costs after myeloablative conditioning were € 192,566 and € 213,050, respectively. Compared to single transplants, double cord blood transplantation was associated with supplementary costs of € 21,302 and € 32,420 up to 4 years, but with increases in quality-adjusted life-years of 0.616 and 0.484, respectively, and incremental cost-effectiveness ratios of € 34,581 and €66,983 in the myeloablative and reduced intensity conditioning settings, respectively. Our results showed that for adults with acute leukemia in first complete remission in France, double cord transplantation is more cost-effective than single cord blood transplantation, with better outcomes, including quality-adjusted life-years.
- Published
- 2014
- Full Text
- View/download PDF
22. Syngeneic transplantation in aplastic anemia: pre-transplant conditioning and peripheral blood are associated with improved engraftment: an observational study on behalf of the Severe Aplastic Anemia and Pediatric Diseases Working Parties of the European Group for Blood and Marrow Transplantation
- Author
-
Sabine Gerull, Martin Stern, Jane Apperley, Dietrich Beelen, Lorentz Brinch, Donald Bunjes, Andrew Butler, Arnold Ganser, Ardeshir Ghavamzadeh, Mickey B Koh, Mieczyslaw Komarnicki, Nicolaus Kröger, Johan Maertens, Alexei Maschan, Christina Peters, Montserrat Rovira, Henrik Sengeløv, Gerard Socié, Johanna Tischer, Rosi Oneto, Jakob Passweg, and Judith Marsh
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Aplastic anemia is usually treated with immunosuppression or allogeneic transplant, depending on patient and disease characteristics. Syngeneic transplant offers a rare treatment opportunity with minimal transplant-related mortality, and offers an insight into disease mechanisms. We present here a retrospective analysis of all syngeneic transplants for aplastic anemia reported to the European Group for Blood and Marrow Transplantation. Between 1976 and 2009, 88 patients received 113 transplants. Most transplants (n=85) were preceded by a conditioning regimen, 22 of these including anti-thymocyte globulin. About half of transplants with data available (39 of 86) were followed by posttransplant immunosuppression. Graft source was bone marrow in the majority of cases (n=77). Transplant practice changed over time with more transplants with conditioning and anti-thymocyte globulin as well as peripheral blood stem cells performed in later years. Ten year overall survival was 93% with 5 transplant-related deaths. Graft failure occurred in 32% of transplants. Risk of graft failure was significantly increased in transplants without conditioning, and with bone marrow as graft source. Lack of posttransplant immunosuppression also showed a trend towards increased risk of graft failure, while anti-thymocyte globulin did not have an influence. In summary, syngeneic transplant is associated with a significant risk of graft failure when no conditioning is given, but has an excellent long-term outcome. Furthermore, our comparatively large series enables us to recommend the use of pre-transplant conditioning rather than not and possibly to prefer peripheral blood as a stem cell source.
- Published
- 2013
- Full Text
- View/download PDF
23. Allogeneic stem cell transplantation in paroxysmal nocturnal hemoglobinuria
- Author
-
Régis Peffault de Latour, Hubert Schrezenmeier, Andrea Bacigalupo, Didier Blaise, Carmino A. de Souza, Stephane Vigouroux, Roelf Willemze, Louis Terriou, Andre Tichelli, Mohamad Mohty, Sophie de Guibert, Judith C. Marsh, Jakob Passweg, Jean Yves Mary, and Gerard Socié
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Background In the era of eculizumab, identifying patients with paroxysmal nocturnal hemoglobinuria who may benefit from allogeneic stem cell transplantation is challenging.Design and Methods We describe the characteristics and overall survival of 211 patients transplanted for paroxysmal nocturnal hemoglobinuria in 83 EBMT centers from 1978 to 2007. Next, we conducted a comparison with a cohort of 402 non-transplanted patients with paroxysmal nocturnal hemoglobinuria diagnosed between 1950 and 2005 in 92 French centers. We compared the occurrence of complications (i.e. thromboembolism and aplastic anemia) using either an individual or a stratum-matching procedure.Results After a median follow-up of 5 years, the 5-year overall survival rate ± standard error (%) was 68±3 in the transplanted group (54±7 in the case of thromboembolism, 69±5 in the case of aplastic anemia without thromboembolism and 86±6 in the case of recurrent hemolytic anemia without thromboembolism or aplastic anemia). Only thromboembolism as the indication for transplantation was associated with worse outcome (P=0.03). We identified 24 pairs of transplanted and non-transplanted patients with thromboembolism for the matched comparison, with worse overall survival for the transplanted patients (hazard ratio=10.0; 95% confidence interval, 1.3-78.1; P=0.007). This was confirmed by the global matching procedure (P=0.03). As regards aplastic anemia without thromboembolism, 30 pairs were identified for the matched comparison. It was not observed that transplanted patients had a significantly worse overall survival (hazard ratio=4.0; 95% confidence interval, 0.9-18.9; P=0.06). A global matching procedure was not feasible.Conclusions Allogeneic stem cell transplantation is probably not a suitable treatment option for life-threatening thromboembolism in paroxysmal nocturnal hemoglobinuria.
- Published
- 2012
- Full Text
- View/download PDF
24. Impact of age on outcomes after bone marrow transplantation for acquired aplastic anemia using HLA-matched sibling donors
- Author
-
Vikas Gupta, Mary Eapen, Ruta Brazauskas, Jeanette Carreras, Mahmoud Aljurf, Robert Peter Gale, Gregory A. Hale, Osman Ilhan, Jakob R. Passweg, Ollé Ringdén, Mitchell Sabloff, Hubert Schrezenmeier, Gerard Socié, and Judith C.W. Marsh
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Background Transplantation from an HLA-matched sibling is the treatment of choice for young patients with acquired severe aplastic anemia. For older patients, the acceptable upper age limit for transplantation as first-line treatment varies. The current analysis, therefore, sought to identify age or ages at transplantation at which survival differed.Design and Methods We studied the effect of patients’ age, adjusting for other significant factors affecting outcomes, in 1307 patients with severe aplastic anemia after HLA-matched sibling transplantation using logistic and Cox regression analysis. Age categories (40 years) were determined using Martingale residual plots for overall survival and categories based on differences in survival.Results Patients aged over 40 years old were more likely to have had immunosuppressive therapy, a poor performance score and a longer interval between diagnosis and transplantation. Neutrophil recovery was similar in all age groups but patients aged over 40 years had a lower likelihood of platelet recovery compared to patients aged less than 20 years (OR 0.45, P=0.01) but not compared to those aged 20–40 years (OR 0.60, P=0.10). Compared to the risk of mortality in patients aged less than 20 years, mortality risks were higher in patients over 40 years old (RR 2.70, P
- Published
- 2010
- Full Text
- View/download PDF
25. Long-term immune deficiency after allogeneic stem cell transplantation: B-cell deficiency is associated with late infections
- Author
-
Elise Corre, Maryvonnick Carmagnat, Marc Busson, Regis Peffault de Latour, Marie Robin, Patricia Ribaud, Antoine Toubert, Claire Rabian, and Gerard Socié
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Immune reconstitution was analyzed in 140 consecutive patients who were 2-year disease-free and who underwent myeloablative allogeneic transplantation. A CD4 and CD8 defect was observed involving naive, terminally differentiated, memory and competent cells and above limits values for activated subsets. Natural killer cells normalize at six months while we observed expansion of CD19+/CD5+ B cells after three months and a persisting defect of memory B cells. Chronic graft-versus-host disease did not influence significantly those parameters for CD8 subsets while the naïve and competent CD4 subsets were strongly affected. But the most profound impact of chronic graft-versus-host disease was on B-cell subsets, especially on the memory B population. The cumulative incidence of late severe infections was low (14% at four years). Using Cox’s models, only low B-cell counts at 12 (P=0.02) and 24 (P=0.001) months were associated with the hazard of developing late infection, in particular if patients did not develop chronic graft-versus-host disease.
- Published
- 2010
- Full Text
- View/download PDF
26. Diagnostic criteria for hematopoietic stem cell transplant-associated microangiopathy: results of a consensus process by an International Working Group
- Author
-
Tapani Ruutu, Giovanni Barosi, Richard J. Benjamin, Richard E. Clark, James N. George, Alois Gratwohl, Ernst Holler, Massimo Iacobelli, Karim Kentouche, Bernhard Lämmle, Joel L. Moake, Paul Richardson, Gerard Socié, Zella Zeigler, Dietger Niederwieser, and Tiziano Barbui
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Background and Objectives There are no widely accepted criteria for the definition of hematopoietic stem cell transplant-associated microangiopathy (TAM). An International Working Group was formed to develop a consensus formulation of criteria for diagnosing clinically significant TAM.Design and Methods The participants proposed a list of candidate criteria, selected those considered necessary, and ranked those considered optional to identify a core set of criteria. Three obligatory criteria and four optional criteria that ranked highest formed a core set. In an appropriateness panel process, the participants scored the diagnosis of 16 patient profiles as appropriate or not appropriate for TAM. Using the experts’ ratings on the patient profiles as a gold standard, the sensitivity and specificity of 24 candidate definitions of the disorder developed from the core set of criteria were evaluated. A nominal group technique was used to facilitate consensus formation. The definition of TAM with the highest score formed the final proposal.Results The Working Group proposes that the diagnosis of TAM requires fulfilment of all of the following criteria: (i) >4% schistocytes in blood; (ii) de novo, prolonged or progressive thrombocytopenia (platelet count
- Published
- 2007
- Full Text
- View/download PDF
27. Outcome of patients with acquired aplastic anemia given first line bone marrow transplantation or immunosuppressive treatment in the last decade: a report from the European Group for Blood and Marrow Transplantation
- Author
-
Anna Locasciulli, Rosi Oneto, Andrea Bacigalupo, Gerard Socié, Elisabeth Korthof, Albert Bekassy, Hubert Schrezenmeier, Jakob Passweg, and Monika Führer
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Background and Objectives The treatment of acquired aplastic anemia (AA) is based on allogeneic bone marrow transplantation (BMT) and immunosuppressive therapy. The aim of this study was to assess the outcome of children and adults with AA treated in the last decade, and to determine whether results have improved in two sequential time periods: 1991–1996 and 1997–2002.Design and Methods We studied 2479 consecutive patients with AA, classified according to first-line treatment, BMT (n=1567) or immunosuppressive therapy (n=912), and stratified according to two sequential time periods. Analyses included variables related to the patients, disease and transplant.Results The actuarial 10-year survival was 73% and 68% for patients treated with BMT or immunosuppression, respectively (p=0.002). BMT outcome improved significantly with time (69% and 77%, p=001) for both matched sibling donor (MSD) (74% and 80%; p=0.003) and alternative donor (38% and 65% p=0.0001) transplants, and was better in children (79% versus 68%, p
- Published
- 2007
- Full Text
- View/download PDF
28. Fludarabine or cyclophosphamide in combination with total body irradiation as myeloablative conditioning prior to allogeneic hematopoietic cell transplantation for acute lymphoblastic leukemia: an analysis by the Acute Leukemia Working Party of the EBMT
- Author
-
Sebastian Giebel, Myriam Labopin, Gerard Socié, Mahmoud Aljurf, Urpu Salmenniemi, Hélène Labussière-Wallet, Micha Srour, Nicolaus Kröger, Mohsen Al Zahrani, Bruno Lioure, Péter Reményi, Mutlu Arat, Jean Henri Bourhis, Grzegorz Helbig, Abdelghani Tbakhi, Edouard Forcade, Anne Huynh, Eolia Brissot, Alexandros Spirydonidis, Bipin N. Savani, Zinaida Peric, Arnon Nagler, and Mohamad Mohty
- Subjects
Transplantation ,Hematology - Published
- 2023
29. Total body irradiation versus busulfan based intermediate intensity conditioning for stem cell transplantation in ALL patients >45 years—a registry-based study by the Acute Leukemia Working Party of the EBMT
- Author
-
Klaus Hirschbühl, Myriam Labopin, Emmanuelle Polge, Didier Blaise, Jean Henri Bourhis, Gerard Socié, Edouard Forcade, Ibrahim Yakoub-Agha, Hélène Labussière-Wallet, Wolfgang Bethge, Patrice Chevallier, Sarah Bonnet, Matthias Stelljes, Alexandros Spyridonidis, Zinaida Peric, Eolia Brissot, Bipin Savani, Sebastian Giebel, Christoph Schmid, Fabio Ciceri, Arnon Nagler, and Mohamad Mohty
- Subjects
Transplantation ,ddc:610 ,Hematology - Abstract
Allogeneic hematopoietic cell transplantation is a potentially curative treatment in high-risk acute lymphoblastic leukemia (ALL). Conditioning regimens based on ≥12 Gray total body irradiation (TBI) represent the current standard in patients ≤45 years, whereas elderly patients frequently receive intermediate intensity conditioning (IIC) to reduce toxicity. To evaluate the role of TBI as a backbone of IIC in ALL, a retrospective, registry-based study included patients >45 years transplanted from matched donors in first complete remission, who had received either fludarabine/TBI 8 Gy (FluTBI8, n = 262), or the most popular, irradiation-free alternative fludarabine/busulfan, comprising busulfan 6.4 mg/kg (FluBu6.4, n = 188) or 9.6 mg/kg (FluBu9.6, n = 51). At two years, overall survival (OS) was 68.5%, 57%, and 62.2%, leukemia-free survival (LFS) was 58%, 42.7%, and 45%, relapse incidence (RI) was 27.2%, 40%, and 30.9%, and non-relapse-mortality (NRM) was 23.1%, 20.7%, and 26.8% for patients receiving FluTBI8Gy, FluBu6.4, and FluBu9.6, respectively. In multivariate analysis, the risk of NRM, acute and chronic graft-versus-host disease was not influenced by conditioning. However, RI was higher after FluBu6.4 (hazard ratio [HR] [95% CI]: 1.85 [1.16–2.95]), and LFS was lower after both FluBu6.4 (HR: 1.56 [1.09–2.23]) and FluBu9.6 (HR: 1.63 [1.02–2.58]) as compared to FluTBI8. Although only resulting in a non-significant advantage in OS, this observation indicates a stronger anti-leukemic efficacy of TBI-based intermediate intensity conditioning.
- Published
- 2023
30. Matched related versus unrelated versus haploidentical donors for allogeneic transplantation in AML patients achieving first complete remission after two induction courses
- Author
-
Arnon Nagler, Myriam Labopin, Stephan Mielke, Jakob Passweg, Didier Blaise, Tobias Gedde-Dahl, Jan J. Cornelissen, Urpu Salmenniemi, Ibrahim Yakoub-Agha, Péter Reményi, Gerard Socié, Gwendolyn van Gorkom, Hélène Labussière-Wallet, Xiao-Jun Huang, Marie Thérèse Rubio, Jenny Byrne, Charles Craddock, Laimonas Griškevičius, Fabio Ciceri, Mohamad Mohty, and Hematology
- Subjects
RISK ,Transplantation ,BLOOD ,SURVIVAL ,GRAFT ,STEM-CELL TRANSPLANTATION ,Hematology ,ACUTE MYELOID-LEUKEMIA ,VALIDATION - Abstract
We compared transplants (HSCT) from matched related siblings (MSD) with those from matched 10/10 and mismatched 9/10 unrelated (UD) and T-replete haploidentical (Haplo) donors in acute myeloid leukemia (AML) in first complete remission (CR1) achieved after two inductions, a known poor prognostic factor. One thousand two hundred and ninety-five patients were included: MSD (n = 428), UD 10/10 (n = 554), UD 9/10 (n = 135), and Haplo (n = 178). Acute GVHD II–IV was higher in all groups compared to MSD. Extensive chronic (c) GVHD was significantly higher in UD 9/10 (HR = 2.52; 95% CI 1.55–4.11, p = 0.0002) and UD 10/10 (HR = 1.48; 95% CI 1.03–2.13, p = 0.036) and cGVHD all grades were higher in UD 9/10 vs MSD (HR = 1.77; 95% CI 1.26–2.49, p = 0.0009). Non-relapse mortality was higher in all groups compared to MSD. Relapse incidence, leukemia-free, and overall survival did not differ significantly between donor types. Finally, GVHD-free relapse-free survival was lower in HSCT from UD 9/10 (HR = 1.56, 95% CI 1.20–2.03, p = 0.0009) but not in those from UD 10/10 (HR = 1.13, p = 0.22) and Haplo donors (HR = 1.12, p = 0.43) compared to MSD. In conclusion, in AML patients undergoing HSCT in CR1 achieved after two induction courses 10/10 UD and Haplo but not 9/10 UD donors are comparable alternatives to MSD.
- Published
- 2023
31. Data from Evaluation of Trends and Prognosis Over Time in Patients with AML Relapsing After Allogeneic Hematopoietic Cell Transplant Reveals Improved Survival for Young Patients in Recent Years
- Author
-
Mohamad Mohty, Arnon Nagler, Bipin N. Savani, Jordi Esteve, Gesine Bug, Alexandros Spyridonidis, Iman Abou Dalle, Fabio Ciceri, Jaime Sanz, Didier Blaise, Gerard Socié, Riitta Niittyvuopio, Victoria Potter, Igor Wolfgang Blau, Dietrich Beelen, Myriam Labopin, Christoph Schmid, and Ali Bazarbachi
- Abstract
Purpose:Relapsed acute myeloid leukemia (AML) post allogeneic hematopoietic cell transplantation (allo-HCT) has a dismal prognosis.Experimental Design:To assess prognosis of patients with recurrent AML post allo-HCT over time, we analyzed European Society for Blood and Marrow Transplantation registry data of 8,162 adult patients with AML who relapsed between 2000 and 2018 after allo-HCT performed in first complete remission from matched sibling, unrelated, or haploidentical donors.Results:The 2-year overall survival (OS) rate from relapse was 17%. For 3,630 patients, P = 0.001). Improvement over time was noted both after relapse within and beyond 6 months from allo-HCT. On multivariate analysis among patients P < 0.02 for 2010–2014 and HR, 0.72; P = 0.0002 for 2015–2018), good performance status, favorable cytogenetics, and longer time from transplant to relapse, but negatively affected by increasing age. In contrast, among 4,532 patients, >50 years of age, the year of relapse had no influence on OS (16% for 2000–2004 and 14% for 2015–2018; P = 0.56). Regarding treatment, encouraging results were observed after second allo-HCT, which was performed within 2 years after relapse in 17% of the entire cohort, resulting in a 2-year OS of 30.7%.Conclusions:Outcome after posttransplant relapse among younger patients has improved significantly in recent years, likely reflecting, among other factors, the efficacy of posttransplant salvage including second allo-HCT.
- Published
- 2023
32. Supplementary Data from Evaluation of Trends and Prognosis Over Time in Patients with AML Relapsing After Allogeneic Hematopoietic Cell Transplant Reveals Improved Survival for Young Patients in Recent Years
- Author
-
Mohamad Mohty, Arnon Nagler, Bipin N. Savani, Jordi Esteve, Gesine Bug, Alexandros Spyridonidis, Iman Abou Dalle, Fabio Ciceri, Jaime Sanz, Didier Blaise, Gerard Socié, Riitta Niittyvuopio, Victoria Potter, Igor Wolfgang Blau, Dietrich Beelen, Myriam Labopin, Christoph Schmid, and Ali Bazarbachi
- Abstract
Supplementary tables
- Published
- 2023
33. Post-transplant cyclophosphamide in acute leukemia patients receiving more than 5/10 HLA-mismatched allogeneic hematopoietic cell transplantation from related donors: A study on behalf of the ALWP of the EBMT
- Author
-
Michele Wieczorek, Myriam Labopin, Luca Castagna, Eolia Brissot, Gerard Socié, Anna Maria Raiola, Emanuele Angelucci, Arancha Bermúdez Rodríguez, Ibrahim Yakoub‐Agha, Mahmoud Aljurf, Charles Crawley, Jean Baptiste Mear, Maurizio Musso, Renato Fanin, Daniele Avenoso, Pascal Turlure, Cristina Tecchio, Jaime Sanz, Fabio Ciceri, Arnon Nagler, and Mohamad Mohty
- Subjects
Hematology - Published
- 2023
34. Cytogenetic risk classification maintains its prognostic significance in transplanted FLT3‐ITD mutated acute myeloid leukemia patients: On behalf of the <scp>acute leukemia working party</scp> / <scp>European society of blood and marrow transplantation</scp>
- Author
-
Arnon Nagler, Myriam Labopin, Charles Craddock, Gerard Socié, Ibrahim Yakoub‐Agha, Tobias Gedde‐Dahl, Riitta Niittyvuopio, Jennifer Louise Byrne, Jan J. Cornelissen, Hélène Labussière‐Wallet, William Arcese, Noel Milpied, Jordi Esteve, Jonathan Canaani, and Mohamad Mohty
- Subjects
Hematology - Published
- 2022
35. Comorbidities in recipients of low transplant conditioning intensity regimens for acute myeloid leukemia: an ALWP EBMT study
- Author
-
Joshua Alexander, Fein, Roni, Shouval, Jacques-Emmanuel, Galimard, Myriam, Labopin, Gerard, Socié, Jürgen, Finke, Jan J, Cornelissen, Ram, Malladi, Maija, Itälä-Remes, Patrice, Chevallier, Kim, Orchard, Donald, Bunjes, Mahmoud, Aljurf, Marie-Thérèse, Rubio, Jurjen, Versluis, Mohamad, Mohty, and Arnon, Nagler
- Abstract
Older age and high burden of comorbidities often drive selection of low-intensity conditioning regimens in allogeneic-hematopoietic stem cell transplantation (HSCT) recipients. However, the impact of comorbidities in the low-intensity conditioning setting is unclear. We sought to determine the contribution of individual comorbidities and their cumulative burden on the risk of non-relapse mortality (NRM) in patients receiving low-intensity regimens. In a retrospective analysis of adults (≥ 18 years) transplanted for acute myeloid leukemia (AML) in first complete remission (CR) between 2008-2018, we studied recipients of low-intensity regimens as defined by the Transplantation Conditioning Intensity (TCI) scale. Multivariable Cox models were constructed to study associations of comorbidities with NRM. Comorbidities identified as putative risk factors in the low-TCI setting were included in combined multivariable regression models assessed for overall survival, NRM, and relapse. A total of 1,663 patients with a median age of 61 years received low-TCI regimens. Cardiac comorbidity (including arrhythmia/valvular disease) and psychiatric disease were associated with increased NRM risk (hazard ratio [HR] 1.54 [95% CI 1.13, 2.09] and 1.69 [1.02, 2.82], respectively). Moderate pulmonary dysfunction, though prevalent, was not associated with increased NRM. In a combined model, cardiac, psychiatric, renal, and inflammatory bowel disease were independently associated with adverse transplantation outcomes. These findings may inform patient and regimen selection and reinforce the need for further investigation of cardioprotective transplantation approaches.
- Published
- 2022
36. Chronic GvHD NIH Consensus Project Biology Task Force: Evolving path to personalized treatment of chronic GvHD
- Author
-
Nataliya Prokopenko Buxbaum, Gerard Socié, Geoffrey R Hill, Kelli PA MacDonald, Victor Tkachev, Takanori Teshima, Stephanie J Lee, Jerome Ritz, Stefanie Sarantopoulos, Leo Luznik, Defu Zeng, Sophie Paczesny, Paul J. Martin, Steven Z Pavletic, Kirk R Schultz, and Bruce R. Blazar
- Subjects
Hematology - Abstract
Chronic GvHD (cGvHD) remains a prominent barrier to allogeneic hematopoietic stem cell transplantion as the leading cause of non-relapse mortality and significant morbidity. Tremendous progress has been achieved in both understanding of pathophysiology and the development of new therapies for cGvHD. While our field has historically approached treatment from an empiric position, research performed at the bedside and bench has elucidated some of the complex pathophysiology of cGvHD. From the clinical perspective, there is significant variability of disease manifestations between individual patients, pointing to diverse biological underpinnings. Capitalizing on progress made to date, the field is now focused on establishing personalized treatment approaches. The manuscript's intent is to concisely review recent knowledge gained and formulate a path towards patient-specific cGvHD therapy.
- Published
- 2022
37. Trends in outcome of transplantation in patients with secondary acute myeloid leukemia: an analysis from the Acute Leukemia Working Party (ALWP) of the EBMT
- Author
-
Arnon Nagler, Maud Ngoya, Jacques-Emmanuel Galimard, Myriam Labopin, Nicolaus Kröger, Gerard Socié, Tobias Gedde-Dahl, Victoria Potter, Thomas Schroeder, Uwe Platzbecker, Arnold Ganser, Didier Blaise, Urpu Salmenniemi, Johan Maertens, Charles Craddock, Hélène Labussière-Wallet, Ibrahim Yakoub-Agha, Bipin Savani, and Mohamad Mohty
- Subjects
Transplantation ,Leukemia, Myeloid, Acute ,Transplantation Conditioning ,Recurrence ,Remission Induction ,Medizin ,Hematopoietic Stem Cell Transplantation ,Humans ,Graft vs Host Disease ,Neoplasms, Second Primary ,Hematology ,Middle Aged ,Retrospective Studies - Abstract
Trends in outcome of transplantation (HSCT) in secondary acute myeloid leukemia (sAML) are limited. We evaluated results of HSCT in 4224 patients with sAML in complete remission; 1337 were transplanted in 2000-2010 and 2887 in 2011-2020. Median age was 54 (range, 18-74) and 59 (range, 18-78) years, respectively (p 0.0001). Donors were MSD in 65% vs. 37%, 10/10 UD in 27% vs. 50%, and 9/10 UD in 8% vs. 13%, respectively (p 0.0001). Conditioning was myeloablative in 46% and 38%, respectively. Two-year non-relapse mortality (NRM) was lower in patients transplanted in 2011-2020 vs. those transplanted in 2000-2010, 18% vs. 21% (hazard ratio (HR) = 0.82, 95% CI: 0.68-0.9; p = 0.04) and modified GVHD-free, relapse-free survival (GRFS) (HR = 0.9, 95% CI: 0.81-0.99; p = 0.04) was better in patients transplanted in the 2011-2020 vs. those transplanted in 2000-2010. Two-year relapse incidence (RI) was similar between the 2 groups with 32% vs. 31%, (HR = 1.05, 95% CI: 0.9-1.22; p = 0.55). Likewise, leukemia-free survival (LFS) (HR = 0.95, 95% CI: 0.84-1.07; p = 0.38) and overall survival (OS) (HR = 0.93, 95% CI: 0.82-1.05; p = 0.26) were not significantly different between the two periods. In conclusion, Incidence of NRM has been significantly reduced and GRFS significantly increased in HSCT for sAML in the last 2 decades.
- Published
- 2022
38. Lower relapse incidence with HAPLO versus MSD or MUD HCTs for AML patients with KMT2A rearrangement: a study from the Global Committee and the ALWP of the EBMT
- Author
-
Yishan Ye, Myriam Labopin, Jia Chen, Depei Wu, Tobias Gedde-Dahl, Didier Blaise, Gérard Socie, Edouard Forcade, Urpu Salmenniemi, Sébastien Maury, Jurjen Versluis, Ali Bazarbachi, Arnon Nagler, Eolia Brissot, Lin Li, Yi Luo, Jimin Shi, Fabio Ciceri, He Huang, Mohamad Mohty, and Norbert Claude Gorin
- Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2024
- Full Text
- View/download PDF
39. Non-T depleted haploidentical stem cell transplantation in AML patients achieving first complete remission after one versus two induction courses: a study from the ALWP/EBMT
- Author
-
Arnon Nagler, Myriam Labopin, Xiao-jun Huang, Didier Blaise, William Arcese, Mercedes Colorado Araujo, Gerard Socié, Edouard Forcade, Fabio Ciceri, Jonathan Canaani, Sebastian Giebel, Eolia Brissot, Jaime Sanz Caballer, Ali Bazarbachi, Ibrahim Yakoub-Agha, Mohamad Mohty, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, and Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Adult ,Transplantation ,Leukemia, Myeloid, Acute ,Transplantation Conditioning ,Remission Induction ,Hematopoietic Stem Cell Transplantation ,Graft vs Host Disease ,Humans ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Hematology ,ComputingMilieux_MISCELLANEOUS ,Retrospective Studies - Abstract
There are no data indicating whether the number of induction courses needed to achieve first complete remission (CR1) is of prognostic significance in Haploidentical transplantation (HaploSCT). We compared transplantation outcomes of adults with AML that underwent HaploSCT in CR1, achieved following one or two induction courses. A total of 635 patients were included: 469 (74%) with 1 and 166 (26%) with two induction chemotherapy courses. A total of 429 (91.5%) and 151 (91%) patients had de novo AML and 40 (8.5%) and 15 (9%) had secondary AML (p = 0.84). Engraftment rates were 97.2 and 97.6%. Day 180 incidence of acute GVHD II-IV and III-IV was similar in both induction groups (31.1 and 34.8%, and 10 and 10.6 %), as was 2-4 year total and extensive chronic GVHD (33.7 and 36.5 %, and 12.2 and 12.1%), respectively. Two-year relapse incidence (RI) was higher while leukemia-free survival (LFS), overall survival (OS) and GVHD-free, relapse-free survival (GRFS) were inferior for patients achieving CR1 with 2 vs 1 course and were 29.1% vs 15.1%, 88 (p = 0.001), 56.2% vs 66.9% (p = 0.03), 58.8% vs 72.2% (p = 0.044) and 44% vs 55.6% (p = 0.013), respectively. Non-relapse mortality (NRM) did not differ, 18% vs 14.6% 90 (p = 0.25). These results were confirmed by multivariate analysis.
- Published
- 2022
40. Prognostic value of a new clinically-based classification system in patients with CMML undergoing allogeneic HCT: a retrospective analysis of the EBMT-CMWP
- Author
-
Francesco Onida, Giulia Sbianchi, Aleksandar Radujkovic, Katja Sockel, Nicolaus Kröger, Jorge Sierra, Gerard Socié, Jan Cornelissen, Xavier Poiré, Luděk Raida, Jean Henri Bourhis, Jürgen Finke, Jakob Passweg, Urpu Salmenniemi, Harry C. Schouten, Yves Beguin, Sonja Martin, Eric Deconinck, Arnold Ganser, Samo Zver, Bruno Lioure, Radia Rohini, Linda Koster, Patrick Hayden, Simona Iacobelli, Marie Robin, Ibrahim Yakoub-Agha, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Hematologie (9), Interne Geneeskunde, and Hematology
- Subjects
Transplantation ,Leukemia ,Hematopoietic Stem Cell Transplantation ,CHRONIC MYELOMONOCYTIC LEUKEMIA ,Leukemia, Myelomonocytic, Chronic ,Myelomonocytic ,Hematology ,WORLD-HEALTH-ORGANIZATION ,ASXL1 ,Prognosis ,Settore MED/01 ,Humans ,Chronic ,GENE-MUTATIONS ,PROPOSALS ,Retrospective Studies - Abstract
Recently a new three-group clinical classification was reported by an International Consortium to stratify CMML patients with regard to prognosis. The groups were defined as follows: (1) Myelodysplastic (MD)-CMML: WBC ≤ 10 × 109/l, circulating immature myeloid cells (IMC) = 0, no splenomegaly; (2) MD/MP (overlap)–CMML: WBC 10–20 × 109/l or WBC ≤ 10 × 109/l but IMC > 0 and/or splenomegaly; (3) Myeloproliferative (MP)-CMML: WBC > 20 × 109/l. By analysing EBMT Registry patients who underwent allo-HCT for CMML between 1997 and 2016, we aimed to determine the impact of this classification on transplantation outcome and to make a comparison with the conventional WHO classification (CMML-0/CMML-1/CMML-2). Patient grouping was based on the data registered at time of transplantation, with IMC replaced by peripheral blasts. Among 151 patients included in the analysis, 38% were classified as MD-CMML, 42% as MD/MP-CMML and 20% as MP-CMML. With a median survival of 17 months in the whole series, MD-CMML patients were distinguished as a low-risk group with higher CR rate at transplant and a longer post-transplant 2-year progression-free survival in comparison to others (44.5% vs 33.5%, respectively), whereas the WHO classification was superior in identifying high-risk patients (CMML-2) with inferior survival outcomes.
- Published
- 2022
41. Reduced intensity versus non-myeloablative conditioning regimen for haploidentical transplantation and post-transplantation cyclophosphamide in complete remission acute myeloid leukemia: a study from the ALWP of the EBMT
- Author
-
Raynier Devillier, Jacques-Emmanuel Galimard, Myriam Labopin, Didier Blaise, Anna Maria Raiola, Jiri Pavlu, Luca Castagna, Gerard Socié, Yves Chalandon, Massimo Martino, Friedrich Stölzel, Gesine Bug, Benedetto Bruno, Radovan Vrhovac, Amandine Charbonnier, Attilio Olivieri, Jacques-Olivier Bay, Herrera Arroyo, Ibrahim Yakoub-Agha, Daniele Avenoso, Andreas Neubauer, Stéphanie Nguyen, Edouard Forcade, Eolia Brissot, Bipin Savani, Arnon Nagler, and Mohamad Mohty
- Subjects
Myeloid ,Transplantation ,Aged ,Busulfan ,Cyclophosphamide ,Humans ,Recurrence ,Retrospective Studies ,Transplantation Conditioning ,Transplantation, Haploidentical ,Graft vs Host Disease ,Hematopoietic Stem Cell Transplantation ,Leukemia, Myeloid, Acute ,Leukemia ,reduced intensity ,non-myeloablative ,conditioning ,acute myeloid leukemia ,Hematology ,Acute ,Haploidentical - Abstract
The optimal conditioning regimen prior haploidentical stem cell transplantation (Haplo-SCT) with post transplantation cyclophosphamide (PT-Cy) for acute myeloid leukemia (AML) remains unknown. A non-myeloablative conditioning (NMAC) regimen (cyclophosphamide + fludarabine + TBI 2 Gy [CyFluTBI]) is a safe approach, but relapse incidence remains high in this setting. Alternatively, a reduced intensity conditioning (RIC) regimen combining thiotepa and reduced-dose busulfan with fludarabine (TBF) may decrease AML relapse. However, an excess of toxicity may counterbalance this potential benefit. We retrospectively compared CyFluTBI vs. TBF in CR AML patients who underwent Haplo-SCT with PT-Cy, in two different populations based on age. We analyzed 490 patients. In patients aged
- Published
- 2022
42. Post-transplant cyclophosphamide in one-antigen mismatched unrelated donor transplantation versus haploidentical transplantation in acute myeloid leukemia: a study from the Acute Leukemia Working Party of the EBMT
- Author
-
Giorgia Battipaglia, Jacques-Emmanuel Galimard, Myriam Labopin, Anna Maria Raiola, Didier Blaise, Annalisa Ruggeri, Yener Koc, Zafer Gülbas, Antonin Vitek, Simona Sica, Jose Luiz Diez-Martin, Luca Castagna, Benedetto Bruno, Montserrat Rovira, Ivan Moiseev, Massimo Martino, Giovanni Grillo, Mercedes Colorado Araujo, Claude Eric Bulabois, Stéphanie Nguyen, Gerard Socié, Mutlu Arat, Jiri Pavlu, Johanna Tischer, Hans Martin, Lucia Lopez Corral, Goda Choi, Edouard Forcade, Andrew McDonald, Fabrizio Pane, Ali Bazarbachi, Fabio Ciceri, Arnon Nagler, Mohamad Mohty, Battipaglia, G., Galimard, J. -E., Labopin, M., Raiola, A. M., Blaise, D., Ruggeri, A., Koc, Y., Gulbas, Z., Vitek, A., Sica, S., Diez-Martin, J. L., Castagna, L., Bruno, B., Rovira, M., Moiseev, I., Martino, M., Grillo, G., Araujo, M. C., Bulabois, C. E., Nguyen, S., Socie, G., Arat, M., Pavlu, J., Tischer, J., Martin, H., Corral, L. L., Choi, G., Forcade, E., Mcdonald, A., Pane, F., Bazarbachi, A., Ciceri, F., Nagler, A., Mohty, M., Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, and Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Cyclophosphamide ,Humans ,Retrospective Studies ,Transplantation Conditioning ,Transplantation, Haploidentical ,Unrelated Donors ,Graft vs Host Disease ,Hematopoietic Stem Cell Transplantation ,Leukemia, Myeloid, Acute ,Myeloid ,endocrine system ,Transplantation ,Leukemia ,Leukemia, Myeloid, Acute/therapy ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Hematology ,Acute ,Haploidentical ,Cyclophosphamide/pharmacology ,hemic and lymphatic diseases ,Acute/therapy - Abstract
International audience; Whether to choose Haploidentical (Haplo) or one-antigen mismatched unrelated donor (1Ag-MMUD) hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PTCy) remains an unanswered question. We compared PTCy- Haplo-HCT to PTCy-1Ag-MMUD-HCT for acute myeloid leukemia (AML) in complete remission (three groups: 1Ag-MMUD using peripheral blood (1Ag-MMUD-PB; n = 155); Haplo using bone marrow (Haplo-BM; n = 647) or peripheral blood (Haplo-PB; n = 949)). Haplo-BM and Haplo-PB had a higher non-relapse mortality (NRM) compared to 1Ag-MMUD-PB (HR 2.28, 95% CI 1.23-4.24, p
- Published
- 2022
43. Correction to : Idelalisib treatment prior to allogeneic stem cell transplantation for patients with chronic lymphocytic leukemia: a report from the EBMT chronic malignancies working party
- Author
-
Johannes Schetelig, Patrice Chevallier, Michel van Gelder, Jennifer Hoek, Olivier Hermine, Ronjon Chakraverty, Paul Browne, Noel Milpied, Michele Malagola, Gerard Socié, Julio Delgado, Eric Deconinck, Ghandi Damaj, Sebastian Maury, Dietrich Beelen, Stéphanie Nguyen Quoc, Paneesha Shankara, Arne Brecht, Jiri Mayer, Mathilde Hunault-Berger, Jörg Bittenbring, Catherine Thieblemont, Stéphane Lepretre, Henning Baldauf, Liesbeth C. de Wreede, Olivier Tournilhac, Ibrahim Yakoub-Agha, Nicolaus Kröger, Peter Dreger, Role of intra-Clonal Heterogeneity and Leukemic environment in ThErapy Resistance of chronic leukemias (CHELTER), and Université Clermont Auvergne (UCA)
- Subjects
03 medical and health sciences ,Transplantation ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medizin ,[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology ,Hematology ,ComputingMilieux_MISCELLANEOUS ,030215 immunology - Abstract
The Idelalisib treatment prior to allogeneic stem cell transplantation for patients with chronic lymphocytic leukemia: a report from the EBMT chronic malignancies working party, written by Johannes Schetelig, Patrice Chevallier, Michel van Gelder, Jennifer Hoek, Olivier Hermine, Ronjon Chakraverty, Paul Browne, Noel Milpied, Michele Malagola, Gerard Socié, Julio Delgado, Eric Deconinck, Ghandi Damaj, Sebastian Maury, Dietrich Beelen, Stéphanie Nguyen Quoc, Paneesha Shankara, Arne Brecht, Jiri Mayer, Mathilde Hunault-Berger, Jörg Bittenbring, Catherine Thieblemont, Stéphane Lepretre, Henning Baldauf, Liesbeth C. de Wreede, Olivier Tournilhac, Ibrahim Yakoub-Agha, Nicolaus Kröger, Peter Dreger was originally published Online First without Open Access. After publication in volume 56, issue 3, page 605–613 the author decided to opt for Open Choice and to make the article an Open Access publication. Therefore, the copyright of the article has been changed to © The Author(s) 2020 and the article is forthwith distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/ licenses/by/4.0. Open access funding enabled and organized by Projekt DEAL. Korrektur zu 10.1038/s41409-020-01069-w
- Published
- 2022
44. Prognostic impact of Epstein-Barr virus serostatus in patients with nonmalignant hematological disorders undergoing allogeneic hematopoietic cell transplantation: the study of Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation
- Author
-
Jan Styczynski, Gloria Tridello, Lidia Gil, Per Ljungman, Malgorzata Mikulska, Steffie van der Werf, Nina Simone Knelange, Diana Averbuch, Gerard Socié, Hendrik Veelken, Jean-Hugues Dalle, Mahmoud Aljurf, Alphan Kupesiz, Yves Bertrand, Abdelghani Tbakhi, Boris Afanasyev, Bruno Lioure, Hélène Labussière-Wallet, Xavier Poiré, Johan Maertens, Eefke Petersen, Patrice Chevallier, Noel Milpied, John A. Snowden, Ibrahim Yakoub-Agha, Jan Cornelissen, Nicolaas Schaap, Carlo Dufour, Regis Peffault de Latour, Arjan Lankester, and Simone Cesaro
- Subjects
Oncology ,medicine.medical_specialty ,Acute leukemia ,business.industry ,Incidence (epidemiology) ,Bone marrow failure ,Hematology ,Disease ,medicine.disease ,Lymphoma ,Transplantation ,03 medical and health sciences ,0302 clinical medicine ,Graft-versus-host disease ,hemic and lymphatic diseases ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Serostatus ,business ,030215 immunology - Abstract
BackgroundIn patients with acute leukemia, lymphoma and chronic malignancies, donor and/or recipient Epstein-Barr virus (EBV) seropositive status increases the risk of development of chronic graft-versus-host disease (cGVHD) after allo-hematopoietic cell transplantation (allo-HCT), while it has no influence on other transplant outcomes. No data are available on the impact of EBV serostatus on transplant outcomes in patients with nonmalignant hematological disorders.ObjectiveWe analyzed the influence of the recipient's (R) and donor's (D) EBV serostatus on transplant outcomes (overall survival (OS); relapse-free survival (RFS); relapse incidence (RI); nonrelapse mortality (NRM); acute graft-versus-host disease (aGVHD); cGVHD) in patients with nonmalignant hematological disorders undergoing allo-HCT.Patients and MethodsA total of 2,355 allo-HCTs performed between 1997 and 2016 for acquired bone marrow failure or hemoglobinopathies were included in this retrospective Registry megafile Infectious Diseases Working Party of the European Society of Blood and Marrow Transplantation (IDWP-EBMT) study.ResultsDemographics: The median age of recipient was 17.7 years (range: 0–77), and 50.8% were children. 79.0% of recipients and 75.4% of donors were EBV-seropositive. 67.8% had HCT from a matched family donor, 4.6% from a mismatched family donor, and 27.6% from an unrelated donor (UD). T-cell depletion was performed in vivo and ex vivo in 82.2% and 6.6% of patients, respectively. Conditioning regimen was myeloablative in 63.7% and reduced intensity conditioning (RIC) in 36.3% of patients. The median follow-up was 4.7 years. Transplant outcomes: EBV-seropositive recipients in comparison with EBV-seronegative recipients had lower OS (85.4% vs. 88.4%, p = 0.035) and higher NRM (10.0% vs. 6.4%, p = 0.018). No other significant differences were found for: RI, RFS, and aGVHD or cGVHD with respect to EBV pretransplant serostatus donor and/or recipient. Multivariate analysis: A trend toward higher risk of development of cGVHD (HR = 1.31; p = 0.081) and better survival (HR = 0.78; p = 0.087) in allo-HCT from EBV-seropositive donors was found. Allo-HCT in EBV-seropositive recipients had a trend toward lower risk of development of cGVHD (HR = 0.75; p = 0.065). When four subgroups (R−/D−, R−/D+, R+/D−, R+/D+ EBV serology) were analyzed, the EBV serostatus had no significant impact on OS, RFS, RI, NRM and development of aGVHD or cGVHD.ConclusionsAllo-HCT from EBV-seropositive versus EBV-seronegative donors are at 31% higher risk of cGVHD in patients with nonmalignant hematological disorders undergoing allo-HCT; however this difference is nonsignificant in multivariate analysis.
- Published
- 2020
45. Cytogenetic risk classification maintains its prognostic significance in transplanted FLT3-ITD mutated acute myeloid leukemia patients: On behalf of the acute leukemia working party/European society of blood and marrow transplantation
- Author
-
Arnon, Nagler, Myriam, Labopin, Charles, Craddock, Gerard, Socié, Ibrahim, Yakoub-Agha, Tobias, Gedde-Dahl, Riitta, Niittyvuopio, Jennifer Louise, Byrne, Jan J, Cornelissen, Hélène, Labussière-Wallet, William, Arcese, Noel, Milpied, Jordi, Esteve, Jonathan, Canaani, and Mohamad, Mohty
- Subjects
Adult ,Male ,Adolescent ,Hematopoietic Stem Cell Transplantation ,Middle Aged ,Risk Assessment ,Disease-Free Survival ,Survival Rate ,Leukemia, Myeloid, Acute ,fms-Like Tyrosine Kinase 3 ,Cytogenetic Analysis ,Mutation ,Humans ,Female ,Aged ,Retrospective Studies - Abstract
FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutational status is a pivotal prognosticator in acute myeloid leukemia (AML) patients and significantly increases the risk of disease relapse. However, it remains unclear whether in FLT3-ITD patients referred for allogeneic stem cell transplantation (allo-SCT), baseline cytogenetics significantly impacts clinical outcome. Using the European Society of Blood and Marrow Transplantation registry, we performed a retrospective analysis of 1631 FLT3-ITD AML patients who underwent allo-SCT with the aim of determining the influence of cytogenetic risk category on patient outcomes. Median patient age was 49 years and median follow-up duration was 36 months. Two-year leukemia-free survival (LFS) and incidence of relapse were 54% and 31.6%, respectively. Non-relapse mortality was experienced by 14.4% with a 2-year overall survival (OS) of 60.1%. On multivariate analysis, LFS was significantly lower in patients with intermediate and adverse risk cytogenetics compared with those with favorable risk cytogenetics, (hazard ratio [HR] = 1.48, 95% confidence interval [CI], 1.06-2.06; p = .02), and (HR = 01.65, 95% CI, 1.13-2.40; p = .009), respectively. OS was significantly lower in patients with adverse risk cytogenetics compared with patients with favorable risk cytogenetics (HR = 1.74, 95% CI, 1.16-2.61; p = .008) with a trend toward lower OS in patients with intermediate risk cytogenetics compared to those with favorable risk cytogenetics (HR = 1.43, 95% CI, 1.00-2.05; p = .052). In addition, adverse risk patients and intermediate risk patients experienced higher relapse rates compared with favorable risk patients (HR = 1.83, 95% CI, 1.13-2.94; p = .013 and HR = 1.82, 95% CI, 1.19-2.77; p = .005). Overall, cytogenetic studies aid in refinement of risk stratification in transplanted FLT3-ITD AML patients.
- Published
- 2021
46. Correction: Trends in outcome of transplantation in patients with secondary acute myeloid leukemia: an analysis from the Acute Leukemia Working Party (ALWP) of the EBMT
- Author
-
Arnon Nagler, Maud Ngoya, Jacques-Emmanuel Galimard, Myriam Labopin, Nicolaus Kröger, Gerard Socié, Tobias Gedde-Dahl, Victoria Potter, Thomas Schroeder, Uwe Platzbecker, Arnold Ganser, Didier Blaise, Urpu Salmenniemi, Johan Maertens, Charles Craddock, Hélène Labussière-Wallet, Ibrahim Yakoub-Agha, Bipin Savani, and Mohamad Mohty
- Subjects
Transplantation ,Medizin ,Hematology - Abstract
In the original version of this article, the given and family names of Jacques-Emmanuel Galimard were incorrectly structured. The original article has been corrected. in press
- Published
- 2022
47. Total body irradiation plus fludarabine versus thiotepa, busulfan plus fludarabine as a myeloablative conditioning for adults with acute lymphoblastic leukemia treated with haploidentical hematopoietic cell transplantation. A study by the Acute Leukemia Working Party of the EBMT
- Author
-
Ryszard Swoboda, Myriam Labopin, Sebastian Giebel, Emanuele Angelucci, Mutlu Arat, Mahmoud Aljurf, Simona Sica, Jiri Pavlu, Gerard Socié, Paolo Bernasconi, Luigi Rigacci, Johanna Tischer, Antonio Risitano, Montserrat Rovira, Riccardo Saccardi, Pietro Pioltelli, Gwendolyn Van Gorkom, Antonin Vitek, Bipin N. Savani, Alexandros Spyridonidis, Zinaida Peric, Arnon Nagler, Mohamad Mohty, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Interne Geneeskunde, and MUMC+: MA Hematologie (9)
- Subjects
Adult ,Transplantation ,BLOOD ,Transplantation Conditioning ,Hematopoietic Stem Cell Transplantation ,Graft vs Host Disease ,Hematology ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,EUROPEAN-SOCIETY ,MALIGNANCIES ,Leukemia, Myeloid, Acute ,Recurrence ,CYCLOPHOSPHAMIDE ,Humans ,Busulfan ,Thiotepa ,Vidarabine ,Whole-Body Irradiation ,Retrospective Studies - Abstract
Optimal conditioning for adults with acute lymphoblastic leukemia (ALL) treated with haploidentical hematopoietic cell transplantation (haplo-HCT) and post-transplant cyclophosphamide has not been established so far. We retrospectively compared outcomes for two myeloablative regimens: fludarabine + total body irradiation (Flu-TBI, n = 117) and thiotepa + iv. busulfan + fludarabine (TBF, n = 119). Patients transplanted either in complete remission (CR) or with active disease were included in the analysis. The characteristics of both groups were comparable except for patients treated with TBF were older. In univariate analysis the incidence of non-relapse mortality (NRM) at 2 years was increased for TBF compared to Flu-TBI (31% vs. 19.5%, p = 0.03). There was a tendency towards reduced incidence of relapse after TBF (p = 0.11). Results of multivariate analysis confirmed a reduced risk of NRM using Flu-TBI (HR = 0.49, p = 0.03). In the analysis restricted to patients treated in CR1 or CR2, the use of Flu-TBI was associated with a decreased risk of NRM (HR = 0.34, p = 0.009) but an increased risk of relapse (HR = 2.59, p = 0.01) without significant effect on survival and graft-versus-host disease. We conclude that for haplo-HCT recipients with ALL, Flu-TBI may be preferable for individuals at high risk of NRM while TBF should be considered in cases at high risk of relapse.
- Published
- 2021
48. Favourable Outcome after Treosulfan Based Conditioning in Patients Undergoing an Allogeneic Hematopoietic Cell Transplantation (alloHCT) for the Treatment of Acute Myleloid Leukaemia (AML): A Subgroup Analysis of the Randomized Phase III MC-Fludt.14/L Trial
- Author
-
Friedrich Stölzel, Matthias Stelljes, Dietrich Wilhelm Beelen, Miroslaw Markiewicz, Peter Remenyi, Peter Dreger, Fabio Ciceri, Eva-Maria Wagner-Drouet, Christian Junghanss, Christoph Scheid, Francesca Patriarca, Gerard Socié, Inken Hilgendorf, Alessandro Rambaldi, Kerstin Schaefer-Eckart, Domenico Russo, Goetz Grigoleit, Gerald Wulf, Nadezda Basara, Bertram Glass, Gernot Stuhler, Maria Bieniaszewska, Jochen Casper, Ernst Holler, Fabio Benedetti, Anna Paola Iori, Rudolf Trenschel, and Wolfgang Bethge
- Subjects
Transplantation ,Molecular Medicine ,Immunology and Allergy ,Cell Biology ,Hematology - Published
- 2022
49. Cytogenetic risk score maintains its prognostic significance in AML patients with detectable measurable residual disease undergoing transplantation in remission: On behalf of the acute leukemia working party of the European society for blood and marrow transplantation
- Author
-
Arnon, Nagler, Myriam, Labopin, Jonathan, Canaani, Riitta, Niittyvuopio, Gerard, Socié, Nicolaus, Kröger, Maija, Itäla-Remes, Ibrahim, Yakoub-Agha, Hélène, Labussière-Wallet, Maria P, Gallego-Hernanz, Eric, Deconinck, Patrice, Chevallier, Jürgen, Finke, Jordi, Esteve, and Mohamad, Mohty
- Abstract
While evidence for measurable residual disease (MRD) is a harbinger of inferior outcome in acute myeloid leukemia (AML) patients referred for allogeneic stem cell transplantation (allo-SCT), the exact clinical trajectory of specific patient subsets in this clinical setting is undefined. Using a recently published prognostic cytogenetic model (Canaani et al. Leukemia 2019) we evaluated whether this model applied also to studies of patients with positive MRD. The analysis comprised MRD
- Published
- 2020
50. The outcome of two or more HLA loci mismatched unrelated donor hematopoietic cell transplantation for acute leukemia: an ALWP of the EBMT study
- Author
-
Arnon, Nagler, Bhagirathbhai, Dholaria, Myriam, Labopin, Benedetto, Bruno, Alessandro, Rambaldi, Pietro, Pioltelli, Giorgio, La Nasa, Gerard, Socié, Stephan, Mielke, Marco, Ruggeri, Riccardo, Saccardi, Georg-Nikolaus, Franke, Jürgen, Finke, Bipin N, Savani, Annalisa, Ruggeri, and Mohamad, Mohty
- Subjects
Leukemia, Myeloid, Acute ,HLA Antigens ,Hematopoietic Stem Cell Transplantation ,Graft vs Host Disease ,Humans ,Unrelated Donors ,Retrospective Studies - Abstract
A mismatched unrelated (MMUD) donor represents an alternative therapeutic option for patients who need allogeneic hematopoietic cell transplantation (allo-HCT) and do not have a human leukocyte antigen (HLA) matched donor. We studied outcomes of patients with acute leukemia transplanted from ≥2 HLA allele MMUD. The study population consisted of 465 patients. The median follow-up period was 63 and 75 months in the AML and ALL groups, respectively. The incidence of grade II-IV and grade III-IV acute (a) graft-versus-host disease (GVHD) during the first 100 days was 37% and 16%, respectively. Total and extensive chronic (c) GVHD rates at 2 years were 38% and 17%, respectively. In the entire population, the 5-year relapse incidence (RI), non-relapse mortality (NRM), leukemia-free survival (LFS), overall survival and refined GVHD-free, relapse-free survival (GRFS) was 33%, 31%, 37%, 41%, and 27%, respectively. In the multivariate analysis, HLA-DR mismatch was a poor prognostic factor, giving a significantly higher NRM [hazard ratio (HR), 1.67, p = 0.02]; poorer LFS (HR, 1.42, p = 0.03); OS (HR, 1.46, p = 0.03) and higher aGVHD grade II-IV (HR, 1.46, p = 0.05). In this study, allo-HCT from ≤6/8 HLA allele MMUD in acute leukemia patients resulted in acceptable LFS and refined GRFS. HLA-DR mismatch was a poor prognostic factor.
- Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.