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

Authors :
Wieduwilt, Matthew J.
Metheny, Leland
Zhang, Mei-Jie
Wang, Hai-Lin
Estrada-Merly, Noel
Marks, David, I
Al-Homsi, A. Samer
Muffly, Lori
Chao, Nelson
Rizzieri, David
Gale, Robert Peter
Gadalla, Shahinaz M.
Cairo, Mitchell
Mussetti, Alberto
Gore, Steven
Bhatt, Vijaya Raj
Patel, Sagar S.
Michelis, Fotios, V
Inamoto, Yoshihiro
Badawy, Sherif M.
Copelan, Edward
Palmisiano, Neil
Kharfan-Dabaja, Mohamed A.
Lazarus, Hillard M.
Ganguly, Siddhartha
Bredeson, Christopher
Diaz Perez, Miguel Angel
Cassaday, Ryan
Savani, Bipin N.
Ballen, Karen
Martino, Rodrigo
Wirk, Baldeep
Bacher, Ulrike
Aljurf, Mahmoud
Bashey, Asad
Murthy, Hemant S.
Yared, Jean A.
Aldoss, Ibrahim
Farhadfar, Nosha
Liu, Hongtao
Abdel-Azim, Hisham
Waller, Edmund K.
Solh, Melhem
Seftel, Matthew D.
van der Poel, Marjolein
Grunwald, Michael R.
Liesveld, Jane L.
Kamble, Rammurti T.
McGuirk, Joseph
Munker, Reinhold
Cahn, Jean-Yves
Lee, Jong Wook
Freytes, Cesar O.
Krem, Maxwell M.
Winestone, Lena E.
Gergis, Usama
Nathan, Sunita
Olsson, Richard F.
Verdonck, Leo F.
Sharma, Akshay
Ringden, Olle
Friend, Brian D.
Cerny, Jan
Choe, Hannah
Chhabra, Saurabh
Nishihori, Taiga
Seo, Sachiko
George, Biju
Baxter-Lowe, Lee Ann
Hildebrandt, Gerhard C.
de Lima, Marcos
Litzow, Mark
Kebriaei, Partow
Hourigan, Christopher S.
Abid, Muhammad Bilal
Weisdorf, Daniel J.
Saber, Wael
Wieduwilt, Matthew J.
Metheny, Leland
Zhang, Mei-Jie
Wang, Hai-Lin
Estrada-Merly, Noel
Marks, David, I
Al-Homsi, A. Samer
Muffly, Lori
Chao, Nelson
Rizzieri, David
Gale, Robert Peter
Gadalla, Shahinaz M.
Cairo, Mitchell
Mussetti, Alberto
Gore, Steven
Bhatt, Vijaya Raj
Patel, Sagar S.
Michelis, Fotios, V
Inamoto, Yoshihiro
Badawy, Sherif M.
Copelan, Edward
Palmisiano, Neil
Kharfan-Dabaja, Mohamed A.
Lazarus, Hillard M.
Ganguly, Siddhartha
Bredeson, Christopher
Diaz Perez, Miguel Angel
Cassaday, Ryan
Savani, Bipin N.
Ballen, Karen
Martino, Rodrigo
Wirk, Baldeep
Bacher, Ulrike
Aljurf, Mahmoud
Bashey, Asad
Murthy, Hemant S.
Yared, Jean A.
Aldoss, Ibrahim
Farhadfar, Nosha
Liu, Hongtao
Abdel-Azim, Hisham
Waller, Edmund K.
Solh, Melhem
Seftel, Matthew D.
van der Poel, Marjolein
Grunwald, Michael R.
Liesveld, Jane L.
Kamble, Rammurti T.
McGuirk, Joseph
Munker, Reinhold
Cahn, Jean-Yves
Lee, Jong Wook
Freytes, Cesar O.
Krem, Maxwell M.
Winestone, Lena E.
Gergis, Usama
Nathan, Sunita
Olsson, Richard F.
Verdonck, Leo F.
Sharma, Akshay
Ringden, Olle
Friend, Brian D.
Cerny, Jan
Choe, Hannah
Chhabra, Saurabh
Nishihori, Taiga
Seo, Sachiko
George, Biju
Baxter-Lowe, Lee Ann
Hildebrandt, Gerhard C.
de Lima, Marcos
Litzow, Mark
Kebriaei, Partow
Hourigan, Christopher S.
Abid, Muhammad Bilal
Weisdorf, Daniel J.
Saber, Wael
Publication Year :
2022

Abstract

The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLAmatched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P <_ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P <_ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (<_18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

Details

Database :
OAIster
Notes :
application/pdf, English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1312846437
Document Type :
Electronic Resource
Full Text :
https://doi.org/10.1182.bloodadvances.2021004916