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A comparison between allogeneic stem cell transplantation from unmanipulated haploidentical and unrelated donors in acute leukemia.
J Hematol Oncol. 2017 01 19; 10(1):24.JH

Abstract

BACKGROUND

In the absence of a HLA-matched related or matched unrelated donor, allogeneic stem cell transplantation (allo-SCT) from mismatched unrelated donors or haploidentical donors are potential alternatives for patients with acute leukemia with an indication to allo-SCT. The objective of this study was to compare the outcome of allo-SCT from T cell-replete haploidentical (Haplo) versus matched (MUD 10/10) or mismatched unrelated donor at a single HLA-locus (MMUD 9/10) for patients with acute leukemia in remission.

METHODS

Two hundred sixty-five adult patients with de novo acute leukemia in first or second remission that received a Haplo-SCT between January 2007 and December 2013 were compared with 2490 patients receiving a MUD 10/10 and 813 receiving a MMUD 9/10. Propensity score weighted analysis was conducted in order to control for disease risk imbalances between the groups.

RESULTS

The weighted 3-year non-relapse mortality and relapse incidence were 29 and 30% for Haplo, 21 and 29% for MUD 10/10, and 29 and 25% for MMUD 9/10, respectively. The weighted 3-year leukemia-free survival (LFS) and overall survival (OS) were 41 and 46% for Haplo, 50 and 56% for MUD 10/10, and 46 and 48% for MMUD 9/10, respectively. Using weighted Cox model, both LFS and OS were significantly higher in transplants from MUD 10/10 compared from those in Haplo but not different between transplants from MMUD 9/10 and Haplo. The type of donor was not significantly associated with neither acute nor chronic graft-versus-host disease.

CONCLUSIONS

Patients with acute leukemia in remission have better outcomes if transplanted from a MUD 10/10. We did not find any significant difference in outcome between transplants from MMUD 9/10 and Haplo, suggesting that both can be equally used in the absence of a 10/10 MUD. KEY POINT 1: Better outcomes using fully (10/10) matched unrelated donor for allo-SCT in acute leukemia in remission. KEY POINT 2: Similar outcomes after allo-SCT from unmanipulated haploidentical graft or mismatched (9/10) unrelated donor in acute leukemia in remission.

Authors+Show Affiliations

Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy. EBMT ALWP Office, Hospital Saint Antoine, Paris, France.Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy. EBMT ALWP Office, Hospital Saint Antoine, Paris, France.EBMT ALWP Office, Hospital Saint Antoine, Paris, France. Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France.Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy.University Department of Hematology and BMT, Medical University of Silesia, Katowice, Poland.Department of Hematology, Ospedale Civile, Pescara, Italy.Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China.Department of Bone Marrow Transplantation, University Hospital, Essen, Germany.EBMT ALWP Office, Hospital Saint Antoine, Paris, France. Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France.Center for Clinical Hematology, Queen Elizabeth Hospital, Birmingham, UK.Bone Marrow Transplantation Department, Anadolu Medical Center Hospital, Gebze, Turkey.Division of Hematology II, IRCCS, San Martino University Hospital IST, Genoa, Italy.EBMT ALWP Office, Hospital Saint Antoine, Paris, France. Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Universite Pierre et Marie Curie, INSERM UMRs 938, Paris, France.EBMT ALWP Office, Hospital Saint Antoine, Paris, France. Division of Hematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

28103944

Citation

Piemontese, Simona, et al. "A Comparison Between Allogeneic Stem Cell Transplantation From Unmanipulated Haploidentical and Unrelated Donors in Acute Leukemia." Journal of Hematology & Oncology, vol. 10, no. 1, 2017, p. 24.
Piemontese S, Ciceri F, Labopin M, et al. A comparison between allogeneic stem cell transplantation from unmanipulated haploidentical and unrelated donors in acute leukemia. J Hematol Oncol. 2017;10(1):24.
Piemontese, S., Ciceri, F., Labopin, M., Arcese, W., Kyrcz-Krzemien, S., Santarone, S., Huang, H., Beelen, D., Gorin, N. C., Craddock, C., Gulbas, Z., Bacigalupo, A., Mohty, M., & Nagler, A. (2017). A comparison between allogeneic stem cell transplantation from unmanipulated haploidentical and unrelated donors in acute leukemia. Journal of Hematology & Oncology, 10(1), 24. https://doi.org/10.1186/s13045-017-0394-2
Piemontese S, et al. A Comparison Between Allogeneic Stem Cell Transplantation From Unmanipulated Haploidentical and Unrelated Donors in Acute Leukemia. J Hematol Oncol. 2017 01 19;10(1):24. PubMed PMID: 28103944.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison between allogeneic stem cell transplantation from unmanipulated haploidentical and unrelated donors in acute leukemia. AU - Piemontese,Simona, AU - Ciceri,F, AU - Labopin,M, AU - Arcese,W, AU - Kyrcz-Krzemien,S, AU - Santarone,S, AU - Huang,H, AU - Beelen,D, AU - Gorin,N C, AU - Craddock,C, AU - Gulbas,Z, AU - Bacigalupo,A, AU - Mohty,M, AU - Nagler,A, AU - ,, Y1 - 2017/01/19/ PY - 2016/10/26/received PY - 2017/01/03/accepted PY - 2017/1/21/entrez PY - 2017/1/21/pubmed PY - 2018/2/27/medline SP - 24 EP - 24 JF - Journal of hematology & oncology JO - J Hematol Oncol VL - 10 IS - 1 N2 - BACKGROUND: In the absence of a HLA-matched related or matched unrelated donor, allogeneic stem cell transplantation (allo-SCT) from mismatched unrelated donors or haploidentical donors are potential alternatives for patients with acute leukemia with an indication to allo-SCT. The objective of this study was to compare the outcome of allo-SCT from T cell-replete haploidentical (Haplo) versus matched (MUD 10/10) or mismatched unrelated donor at a single HLA-locus (MMUD 9/10) for patients with acute leukemia in remission. METHODS: Two hundred sixty-five adult patients with de novo acute leukemia in first or second remission that received a Haplo-SCT between January 2007 and December 2013 were compared with 2490 patients receiving a MUD 10/10 and 813 receiving a MMUD 9/10. Propensity score weighted analysis was conducted in order to control for disease risk imbalances between the groups. RESULTS: The weighted 3-year non-relapse mortality and relapse incidence were 29 and 30% for Haplo, 21 and 29% for MUD 10/10, and 29 and 25% for MMUD 9/10, respectively. The weighted 3-year leukemia-free survival (LFS) and overall survival (OS) were 41 and 46% for Haplo, 50 and 56% for MUD 10/10, and 46 and 48% for MMUD 9/10, respectively. Using weighted Cox model, both LFS and OS were significantly higher in transplants from MUD 10/10 compared from those in Haplo but not different between transplants from MMUD 9/10 and Haplo. The type of donor was not significantly associated with neither acute nor chronic graft-versus-host disease. CONCLUSIONS: Patients with acute leukemia in remission have better outcomes if transplanted from a MUD 10/10. We did not find any significant difference in outcome between transplants from MMUD 9/10 and Haplo, suggesting that both can be equally used in the absence of a 10/10 MUD. KEY POINT 1: Better outcomes using fully (10/10) matched unrelated donor for allo-SCT in acute leukemia in remission. KEY POINT 2: Similar outcomes after allo-SCT from unmanipulated haploidentical graft or mismatched (9/10) unrelated donor in acute leukemia in remission. SN - 1756-8722 UR - https://www.unboundmedicine.com/medline/citation/28103944/A_comparison_between_allogeneic_stem_cell_transplantation_from_unmanipulated_haploidentical_and_unrelated_donors_in_acute_leukemia_ L2 - https://jhoonline.biomedcentral.com/articles/10.1186/s13045-017-0394-2 DB - PRIME DP - Unbound Medicine ER -