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Comparable outcomes of haploidentical, 10/10 and 9/10 unrelated donor transplantation in adverse karyotype AML in first complete remission.
Am J Hematol. 2018 10; 93(10):1236-1244.AJ

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is the most powerful therapy preventing relapse in patients with adverse cytogenetics acute myeloid leukemia (AML) in first complete remission (CR1). In the absence of a matched related donor, potential alternatives include 10/10, 9/10 HLA-matched unrelated (UD) or haploidentical (Haplo) donors. We analyzed clinical outcomes of patients undergoing T-cell repleted Haplo (n = 74), 10/10 UD (n = 433) and 9/10 UD HSCT (n = 123) from 2007 to 2015, reported to the EBMT Registry. Adverse risk AML was defined according to the 2017 ELN cytogenetic risk classification. The 2-year nonrelapse mortality was 19% for Haplo, 18% for 10/10 UD and 18% for 9/10 UD (P = .9). The relapse incidence was not significantly affected by donor source, with a 2-year incidence of 27% for Haplo HSCT, 39% for 10/10 UD and 37% for 9/10 UD SCT (P = .3). We show comparable probabilities of leukemia-free survival (LFS) and overall survival (OS) at 2 years among Haplo HSCT, 10/10 UD SCT and 9/10 UD SCT (53% and 59%, 43% and 50%, 44% and 50%, respectively, P = .5 for both parameters). The type of donor was not significantly associated with either acute or chronic graft-vs.-host disease incidence. Using multivariable Cox model, Haplo HSCT recipients experienced comparable OS and LFS to 10/10 and 9/10 UD. In the present series of adverse cytogenetics AML patients in CR1, Haplo HSCT recipients had comparable outcomes to those of 10/10 and 9/10 UDs, suggesting that all these types of HSCT may be considered a valid option in this high risk population.

Authors+Show Affiliations

Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.Université Pierre and Marie Curie, Paris, France. Uniteé de Recherche Mixte en Santeé (UMR_S) 938, INSERM, Paris, France. Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy.Stem Cell Transplantation Unit, Hospital St Louis, APHP, Paris, France.Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands.Hematology Department, Hospital Clínic, IDIBAPS, Barcelona, Spain.Department of Hematology/Oncology and Stem Cell Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.Stem Cell Transplantation Unit, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.Service des Maladies du Sang, Hopital Claude Huriez, CHRU Lille, Lille, France.Queen Elizabeth Hospital, Birmingham, and University of Birmingham, Birmingham, United Kingdom.Hematology, University Hospital of Basel, Basel, Switzerland.Programme de Transplantation and Thérapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France.Department of Medicine, Oslo University Hospital, Oslo, Norway.Clinica di Ematologia, Università Politecnica delle Marche, Ancona, Italy.Département d'Hématologie Clinique, CHU Lapeyronie, Montpellier, France.Université Pierre and Marie Curie, Paris, France. Uniteé de Recherche Mixte en Santeé (UMR_S) 938, INSERM, Paris, France. Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.Université Pierre and Marie Curie, Paris, France. Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30058714

Citation

Lorentino, Francesca, et al. "Comparable Outcomes of Haploidentical, 10/10 and 9/10 Unrelated Donor Transplantation in Adverse Karyotype AML in First Complete Remission." American Journal of Hematology, vol. 93, no. 10, 2018, pp. 1236-1244.
Lorentino F, Labopin M, Bernardi M, et al. Comparable outcomes of haploidentical, 10/10 and 9/10 unrelated donor transplantation in adverse karyotype AML in first complete remission. Am J Hematol. 2018;93(10):1236-1244.
Lorentino, F., Labopin, M., Bernardi, M., Ciceri, F., Socié, G., Cornelissen, J. J., Esteve, J., Ruggeri, A., Volin, L., Yacoub-Agha, I., Craddock, C., Passweg, J., Blaise, D., Gedde-Dahl, T., Poiani, M., Fegueux, N., Mohty, M., & Nagler, A. (2018). Comparable outcomes of haploidentical, 10/10 and 9/10 unrelated donor transplantation in adverse karyotype AML in first complete remission. American Journal of Hematology, 93(10), 1236-1244. https://doi.org/10.1002/ajh.25231
Lorentino F, et al. Comparable Outcomes of Haploidentical, 10/10 and 9/10 Unrelated Donor Transplantation in Adverse Karyotype AML in First Complete Remission. Am J Hematol. 2018;93(10):1236-1244. PubMed PMID: 30058714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparable outcomes of haploidentical, 10/10 and 9/10 unrelated donor transplantation in adverse karyotype AML in first complete remission. AU - Lorentino,Francesca, AU - Labopin,Myriam, AU - Bernardi,Massimo, AU - Ciceri,Fabio, AU - Socié,Gerard, AU - Cornelissen,Jan J, AU - Esteve,Jordi, AU - Ruggeri,Annalisa, AU - Volin,Liisa, AU - Yacoub-Agha,Ibrahim, AU - Craddock,Charles, AU - Passweg,Jacob, AU - Blaise,Didier, AU - Gedde-Dahl,Tobias, AU - Poiani,Monica, AU - Fegueux,Nathalie, AU - Mohty,Mohamad, AU - Nagler,Arnon, AU - ,, Y1 - 2018/09/03/ PY - 2018/05/03/received PY - 2018/07/17/revised PY - 2018/07/18/accepted PY - 2018/7/31/pubmed PY - 2019/6/30/medline PY - 2018/7/31/entrez SP - 1236 EP - 1244 JF - American journal of hematology JO - Am J Hematol VL - 93 IS - 10 N2 - Allogeneic hematopoietic stem cell transplantation (HSCT) is the most powerful therapy preventing relapse in patients with adverse cytogenetics acute myeloid leukemia (AML) in first complete remission (CR1). In the absence of a matched related donor, potential alternatives include 10/10, 9/10 HLA-matched unrelated (UD) or haploidentical (Haplo) donors. We analyzed clinical outcomes of patients undergoing T-cell repleted Haplo (n = 74), 10/10 UD (n = 433) and 9/10 UD HSCT (n = 123) from 2007 to 2015, reported to the EBMT Registry. Adverse risk AML was defined according to the 2017 ELN cytogenetic risk classification. The 2-year nonrelapse mortality was 19% for Haplo, 18% for 10/10 UD and 18% for 9/10 UD (P = .9). The relapse incidence was not significantly affected by donor source, with a 2-year incidence of 27% for Haplo HSCT, 39% for 10/10 UD and 37% for 9/10 UD SCT (P = .3). We show comparable probabilities of leukemia-free survival (LFS) and overall survival (OS) at 2 years among Haplo HSCT, 10/10 UD SCT and 9/10 UD SCT (53% and 59%, 43% and 50%, 44% and 50%, respectively, P = .5 for both parameters). The type of donor was not significantly associated with either acute or chronic graft-vs.-host disease incidence. Using multivariable Cox model, Haplo HSCT recipients experienced comparable OS and LFS to 10/10 and 9/10 UD. In the present series of adverse cytogenetics AML patients in CR1, Haplo HSCT recipients had comparable outcomes to those of 10/10 and 9/10 UDs, suggesting that all these types of HSCT may be considered a valid option in this high risk population. SN - 1096-8652 UR - https://www.unboundmedicine.com/medline/citation/30058714/Comparable_outcomes_of_haploidentical_10/10_and_9/10_unrelated_donor_transplantation_in_adverse_karyotype_AML_in_first_complete_remission_ L2 - https://doi.org/10.1002/ajh.25231 DB - PRIME DP - Unbound Medicine ER -