1. Matched unrelated donor transplantation versus haploidentical transplantation with post-transplant cyclophosphamide in children with acute myeloid leukemia: a PDWP-EBMT study
- Author
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Ruggeri, A, Santoro, N, Galimard, J, Kalwak, K, Algeri, M, Zubarovskaya, L, Czyzewski, K, Skorobogatova, E, Sedlacek, P, Besley, C, Balduzzi, A, Bertrand, Y, Peristeri, J, Fagioli, F, Ifversen, M, Gozdzik, J, Peters, C, Versluijs, B, Biffi, A, Prete, A, Faraci, M, Ghemlas, I, Bodova, I, Aleinikova, O, Dalissier, A, Rocha, V, Corbacioglu, S, Ruggeri A., Santoro N., Galimard J. E., Kalwak K., Algeri M., Zubarovskaya L., Czyzewski K., Skorobogatova E., Sedlacek P., Besley C., Balduzzi A., Bertrand Y., Peristeri J., Fagioli F., Ifversen M., Gozdzik J., Peters C., Versluijs B., Biffi A., Prete A., Faraci M., Ghemlas I., Bodova I., Aleinikova O., Dalissier A., Rocha V., Corbacioglu S., Ruggeri, A, Santoro, N, Galimard, J, Kalwak, K, Algeri, M, Zubarovskaya, L, Czyzewski, K, Skorobogatova, E, Sedlacek, P, Besley, C, Balduzzi, A, Bertrand, Y, Peristeri, J, Fagioli, F, Ifversen, M, Gozdzik, J, Peters, C, Versluijs, B, Biffi, A, Prete, A, Faraci, M, Ghemlas, I, Bodova, I, Aleinikova, O, Dalissier, A, Rocha, V, Corbacioglu, S, Ruggeri A., Santoro N., Galimard J. E., Kalwak K., Algeri M., Zubarovskaya L., Czyzewski K., Skorobogatova E., Sedlacek P., Besley C., Balduzzi A., Bertrand Y., Peristeri J., Fagioli F., Ifversen M., Gozdzik J., Peters C., Versluijs B., Biffi A., Prete A., Faraci M., Ghemlas I., Bodova I., Aleinikova O., Dalissier A., Rocha V., and Corbacioglu S.
- Abstract
In children with acute myeloid leukemia (AML) who lack a human leukocyte antigen (HLA) identical sibling, the donor can be replaced with an HLA-matched unrelated donor (MUD) or a haploidentical donor (haplo). We compared outcomes of patients <18 years with AML in first and second complete remission (CR1 & CR2) undergoing a hematopoietic stem cell transplantation (HCT) either with a MUD with anti-thymocyte globulin (ATG) (N=420) or a haplo HCT with post-transplant cyclophosphamide (PT-CY) (N=96) after a myeloablative conditioning regimen (MAC) between 2011 and 2021, reported to the European Society for Blood and Marrow Transplantation. A matched pair analysis was performed to adjust for differences among groups. The final analysis was performed on 253 MUD and 95 haplo-HCT. In the matched cohort, median age at HCT was 11.2 and 10 years and median year of HCT was 2017 and 2018, in MUD and haplo-HCT recipients, respectively. The risk of grade III-IV acute graft-versus-host disease (aGVHD) was significantly higher in the haplo group (hazard ratio [HR]=2.33, 95% confidence interval [CI]: 1.18-4.58; P=0.01). No significant differences were found in 2 years overall survival (OS; 78.4% vs. 71.5%; HR=1.39, 95% CI: 0.84-2.31; P=0.19), leukemia-free survival (LFS; 72.7% vs. 69.5%; HR=1.22, 95% CI: 0.76-1.95; P=0.41), CI of relapse (RI; 19.3% vs. 19.5%; HR=1.14, 95% CI: 0.62-2.08; P=0.68) non-relapse-mortality (NRM; 8% vs. 11%; HR=1.39, 95% CI: 0.66-2.93; P=0.39) and graft-versus-host free relapse-free survival (GRFS; 60.7% vs. 54.5%, HR=1.38, 95% CI: 0.95-2.02; P=0.09) after MUD and haplo-HCT respectively. Our study suggests that haplo-HCT with PT-CY is a suitable option to transplant children with AML lacking a matched related donor.
- Published
- 2024