Tags

Type your tag names separated by a space and hit enter

Unmanipulated haploidentical bone marrow transplantation and posttransplantation cyclophosphamide for hematologic malignancies after myeloablative conditioning.
Biol Blood Marrow Transplant. 2013 Jan; 19(1):117-22.BB

Abstract

Fifty patients with high-risk hematologic malignancies, underwent an unmanipulated haploidentical bone marrow transplantation (BMT), followed by posttransplantation high-dose cyclophosphamide (PT-CY): the myeloablative (MA) conditioning consisted of thiotepa, busulfan, fludarabine (n = 35), or total body irradiation (TBI), fludarabine (n = 15). The median age was 42 years (range, 18-66 years); 23 patients were in remission, 27 had active disease, and 10 patients were receiving a second allograft. Graft-versus-host disease (GVHD) prophylaxis consisted in PT-CY on day +3 and +5, cyclosporine (from day 0), and mycophenolate (from day +1). Three patients died before engraftment, and 2 patients had autologous recovery: 45 patients (90%) had full-donor chimerism on day +30. The median day for neutrophil engraftment was day +18 (range, 13-30 days). The cumulative incidence of grade II-III acute GVHD (aGVHD) was 12%, and of moderate chronic GVHD (cGVHD) 10%. With a median follow-up for surviving patients of 333 days (range, 149-623 days), the cumulative incidence of transplantation-related mortality (TRM) was 18%, and the rate of relapse was 26%. The actuarial 22-month disease-free survival (DFS) rate was 68% for patients in remission and 37% for patients with active disease (P < .001). Causes of death were pneumonia (n = 3), hemorrhage (n = 3), sepsis (n = 3), and relapse (n = 7). In conclusion, an MA conditioning regimen followed by haploidentical BMT with PT-CY results in a low risk of aGVHD and cGVHD and encouraging rates of TRM and DFS.

Authors+Show Affiliations

Divisione Ematologia e Trapianto di Midollo, IRCCS San Martino, Genova, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22940057

Citation

Raiola, Anna Maria, et al. "Unmanipulated Haploidentical Bone Marrow Transplantation and Posttransplantation Cyclophosphamide for Hematologic Malignancies After Myeloablative Conditioning." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 19, no. 1, 2013, pp. 117-22.
Raiola AM, Dominietto A, Ghiso A, et al. Unmanipulated haploidentical bone marrow transplantation and posttransplantation cyclophosphamide for hematologic malignancies after myeloablative conditioning. Biol Blood Marrow Transplant. 2013;19(1):117-22.
Raiola, A. M., Dominietto, A., Ghiso, A., Di Grazia, C., Lamparelli, T., Gualandi, F., Bregante, S., Van Lint, M. T., Geroldi, S., Luchetti, S., Ballerini, F., Miglino, M., Varaldo, R., & Bacigalupo, A. (2013). Unmanipulated haploidentical bone marrow transplantation and posttransplantation cyclophosphamide for hematologic malignancies after myeloablative conditioning. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 19(1), 117-22. https://doi.org/10.1016/j.bbmt.2012.08.014
Raiola AM, et al. Unmanipulated Haploidentical Bone Marrow Transplantation and Posttransplantation Cyclophosphamide for Hematologic Malignancies After Myeloablative Conditioning. Biol Blood Marrow Transplant. 2013;19(1):117-22. PubMed PMID: 22940057.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unmanipulated haploidentical bone marrow transplantation and posttransplantation cyclophosphamide for hematologic malignancies after myeloablative conditioning. AU - Raiola,Anna Maria, AU - Dominietto,Alida, AU - Ghiso,Anna, AU - Di Grazia,Carmen, AU - Lamparelli,Teresa, AU - Gualandi,Francesca, AU - Bregante,Stefania, AU - Van Lint,Maria Teresa, AU - Geroldi,Simona, AU - Luchetti,Silvia, AU - Ballerini,Filippo, AU - Miglino,Maurizio, AU - Varaldo,Riccardo, AU - Bacigalupo,Andrea, Y1 - 2012/08/29/ PY - 2012/07/11/received PY - 2012/08/23/accepted PY - 2012/9/4/entrez PY - 2012/9/4/pubmed PY - 2013/6/8/medline SP - 117 EP - 22 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 19 IS - 1 N2 - Fifty patients with high-risk hematologic malignancies, underwent an unmanipulated haploidentical bone marrow transplantation (BMT), followed by posttransplantation high-dose cyclophosphamide (PT-CY): the myeloablative (MA) conditioning consisted of thiotepa, busulfan, fludarabine (n = 35), or total body irradiation (TBI), fludarabine (n = 15). The median age was 42 years (range, 18-66 years); 23 patients were in remission, 27 had active disease, and 10 patients were receiving a second allograft. Graft-versus-host disease (GVHD) prophylaxis consisted in PT-CY on day +3 and +5, cyclosporine (from day 0), and mycophenolate (from day +1). Three patients died before engraftment, and 2 patients had autologous recovery: 45 patients (90%) had full-donor chimerism on day +30. The median day for neutrophil engraftment was day +18 (range, 13-30 days). The cumulative incidence of grade II-III acute GVHD (aGVHD) was 12%, and of moderate chronic GVHD (cGVHD) 10%. With a median follow-up for surviving patients of 333 days (range, 149-623 days), the cumulative incidence of transplantation-related mortality (TRM) was 18%, and the rate of relapse was 26%. The actuarial 22-month disease-free survival (DFS) rate was 68% for patients in remission and 37% for patients with active disease (P < .001). Causes of death were pneumonia (n = 3), hemorrhage (n = 3), sepsis (n = 3), and relapse (n = 7). In conclusion, an MA conditioning regimen followed by haploidentical BMT with PT-CY results in a low risk of aGVHD and cGVHD and encouraging rates of TRM and DFS. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/22940057/Unmanipulated_haploidentical_bone_marrow_transplantation_and_posttransplantation_cyclophosphamide_for_hematologic_malignancies_after_myeloablative_conditioning_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(12)00348-5 DB - PRIME DP - Unbound Medicine ER -