Universität zu Köln

Santoro, Nicole, Labopin, Myriam, Giannotti, Federica, Ehninger, Gerard, Niederwieser, Dietger, Brecht, Arne, Stelljes, Matthias, Kroeger, Nicolaus, Einsele, Herman, Eder, Matthias, Hallek, Michael, Glass, Bertram, Finke, Juergen, Ciceri, Fabio, Mohty, Mohamad, Ruggeri, Annalisa and Nagler, Arnon (2018). Unmanipulated haploidentical in comparison with matched unrelated donor stem cell transplantation in patients 60 years and older with acute myeloid leukemia: a comparative study on behalf of the ALWP of the EBMT. J. Hematol. Oncol., 11. LONDON: BIOMED CENTRAL LTD. ISSN 1756-8722

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Abstract

Background: Acute myeloid leukemia (AML) is both more common and with more biologically aggressive phenotype in the elderly. Allogenic stem cell transplantation (allo-SCT) is the best treatment option in fit patients. Either HLA-matched unrelated donor (MUD) or haploidentical (Haplo) donor are possible alternative for patients in need. Methods: We retrospectively compared non-T-cell-depleted Haplo (n = 250) to 10/10 MUD (n = 2589) in AML patients >= 60 years. Results: Median follow-up was 23 months. Disease status at transplant differs significantly between the two groups (p < 10(-4)). Reduced intensity conditioning (RIC) was administrated to 73 and 77% of Haplo and MUD, respectively (p = 0.23). Stem cell source was the bone marrow (BM) in 52% of the Haplo and 6% of MUD (p < 10(-4)). Anti-thymocyte globulin (ATG) was most frequently used in MUD (p < 10(-4)) while post-Tx cyclophosphamide (PT-Cy) was given in 62% of Haplo. Engraftment was achieved in 90% of the Haplo vs 97% of MUD (p < 10(-4)). In multivariate analysis, no significant difference was found between Haplo and MUD for acute (a) graft versus host disease (GVHD) grade II-IV, relapse incidence (RI), non-relapse mortality (NRM), leukemia free survival (LFS), graft-versus-host-free-relapse free survival (GRFS), and overall survival (OS). Extensive chronic (c) GVHD was significantly higher for MUD as compared to Haplo (HR 2, p = 0.01, 95% CI 1.17-3.47). A propensity score analysis confirmed the higher risk of extensive cGVHD for MUD without differences for other outcomes. Conclusions: Allo-SCT from both Haplo and MUD are valid option for AML patients >= 60 years of age with similar results. Transplantation from MUD was associated with higher extensive cGVHD. Our findings suggest that Haplo is a suitable and attractive graft source for patients >= 60 with AML in need of allo-SCT.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Santoro, Nicole UNSPECIFIED UNSPECIFIED UNSPECIFIED Labopin, Myriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Giannotti, Federica UNSPECIFIED UNSPECIFIED UNSPECIFIED Ehninger, Gerard UNSPECIFIED UNSPECIFIED UNSPECIFIED Niederwieser, Dietger UNSPECIFIED UNSPECIFIED UNSPECIFIED Brecht, Arne UNSPECIFIED UNSPECIFIED UNSPECIFIED Stelljes, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Nicolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Einsele, Herman UNSPECIFIED UNSPECIFIED UNSPECIFIED Eder, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Glass, Bertram UNSPECIFIED UNSPECIFIED UNSPECIFIED Finke, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Ciceri, Fabio UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohty, Mohamad UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruggeri, Annalisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Nagler, Arnon UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-189263
DOI:	10.1186/s13045-018-0598-0
Journal or Publication Title:	J. Hematol. Oncol.
Volume:	11
Date:	2018
Publisher:	BIOMED CENTRAL LTD
Place of Publication:	LONDON
ISSN:	1756-8722
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BONE-MARROW-TRANSPLANTATION; 1ST COMPLETE REMISSION; VERSUS-HOST-DISEASE; POSTTRANSPLANTATION CYCLOPHOSPHAMIDE; MYELODYSPLASTIC SYNDROME; ELDERLY-PATIENTS; SIBLING DONORS; ADULTS; OUTCOMES; BLOOD Multiple languages Oncology; Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18926