Tags

Type your tag names separated by a space and hit enter

Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation: an EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine.
J Hematol Oncol. 2018 08 30; 11(1):110.JH

Abstract

BACKGROUND

Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established.

METHODS

This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics.

RESULTS

SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1.03, p = 0.92 or HR = 1.86, p = 0.21) and relapse incidence (HR = 0.8, p = 0.65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2.63, p = 0.001); moreover, SUCBT did worse in terms of overall survival (HR = 2.18, p = 0.002), leukemia-free survival (HR = 1.94, p = 0.007), and GvHD relapse-free survival (HR = 2.38, p = 0.0002).

CONCLUSIONS

Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM.

Authors+Show Affiliations

Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France.Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France. Acute Leukemia Working Party EBMT Paris Office, Hospital Saint- Antoine, Paris, France.Division of Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, 52621, Ramat-Gan, Israel. shouval@gmail.com. Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel. shouval@gmail.com.Hospital Universitari y Politecnic La Fe, Valencia, Spain. Instituto Carlos III, CIBERONC, Madrid, Spain.Rome Transplant Network, ¨Tor Vergata¨ University of Rome, Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy.Hematology and transplant Unit, Ospedale Policlinico San Martino, Genoa, Italy.Hematology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain.Ospedale Civile, Dipartimento di Ematologia, Medicina Trasfusionale e Biotecnologie, Pescara, Italy.S.S.C.V.D Trapianto di Cellule Staminali A.O.U Citta della Salute e della Scienza di Torino, Torino, Italy.Azienda Ospedaliera Papa Giovanni XXIII, Hematology and Bone Marrow Transplant Unit, Bergamo, Italy.Azienda Ospedaliera Universitaria Careggi, Cell Therapy and Transfusion Medicine Unit, Florence, Italy.Programme de Transplantation&Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France.IRCCS, Casa Sollievo della Sofferenza, Department of Hemato-Ooncology, Setm Cell Transplant Unit, San Giovanni Rotondo, Italy.Eurocord, Hôpital Saint Louis, Université Paris-Diderot, Paris, France. Department of Hematology, Churchill Hospital, NHS BT, Oxford University, Oxford, UK. Serviço de Hematologia, Hemoterapia e Terapia Celular, Universidade de São Paulo, São Paulo, SP, Brazil.GIGA-I3, University of Liege, Liege, Belgium.Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France. Acute Leukemia Working Party EBMT Paris Office, Hospital Saint- Antoine, Paris, France.Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France. Department of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children's Hospital, Piazza S Onofrio, 4, 00165, Rome, Italy.Acute Leukemia Working Party EBMT Paris Office, Hospital Saint- Antoine, Paris, France. Division of Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, 52621, Ramat-Gan, Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30165887

Citation

Giannotti, Federica, et al. "Haploidentical Transplantation Is Associated With Better Overall Survival when Compared to Single Cord Blood Transplantation: an EBMT-Eurocord Study of Acute Leukemia Patients Conditioned With Thiotepa, Busulfan, and Fludarabine." Journal of Hematology & Oncology, vol. 11, no. 1, 2018, p. 110.
Giannotti F, Labopin M, Shouval R, et al. Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation: an EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine. J Hematol Oncol. 2018;11(1):110.
Giannotti, F., Labopin, M., Shouval, R., Sanz, J., Arcese, W., Angelucci, E., Sierra, J., Santasusana, J. R., Santarone, S., Benedetto, B., Rambaldi, A., Saccardi, R., Blaise, D., Carella, M. A., Rocha, V., Baron, F., Mohty, M., Ruggeri, A., & Nagler, A. (2018). Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation: an EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine. Journal of Hematology & Oncology, 11(1), 110. https://doi.org/10.1186/s13045-018-0655-8
Giannotti F, et al. Haploidentical Transplantation Is Associated With Better Overall Survival when Compared to Single Cord Blood Transplantation: an EBMT-Eurocord Study of Acute Leukemia Patients Conditioned With Thiotepa, Busulfan, and Fludarabine. J Hematol Oncol. 2018 08 30;11(1):110. PubMed PMID: 30165887.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation: an EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine. AU - Giannotti,Federica, AU - Labopin,Myriam, AU - Shouval,Roni, AU - Sanz,Jaime, AU - Arcese,William, AU - Angelucci,Emanuele, AU - Sierra,Jorge, AU - Santasusana,Josep-Maria Ribera, AU - Santarone,Stella, AU - Benedetto,Bruno, AU - Rambaldi,Alessandro, AU - Saccardi,Riccardo, AU - Blaise,Didier, AU - Carella,Michele Angelo, AU - Rocha,Vanderson, AU - Baron,Frederic, AU - Mohty,Mohamad, AU - Ruggeri,Annalisa, AU - Nagler,Arnon, Y1 - 2018/08/30/ PY - 2018/07/15/received PY - 2018/08/22/accepted PY - 2018/9/1/entrez PY - 2018/9/1/pubmed PY - 2020/1/10/medline KW - Acute myeloid leukemia KW - Conditioning regimens KW - Haploidentical stem cell transplantation KW - Stem cell transplantation KW - Thiotepa-busulfan-fludarabine KW - Umbilical cord blood transplantation SP - 110 EP - 110 JF - Journal of hematology & oncology JO - J Hematol Oncol VL - 11 IS - 1 N2 - BACKGROUND: Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established. METHODS: This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics. RESULTS: SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1.03, p = 0.92 or HR = 1.86, p = 0.21) and relapse incidence (HR = 0.8, p = 0.65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2.63, p = 0.001); moreover, SUCBT did worse in terms of overall survival (HR = 2.18, p = 0.002), leukemia-free survival (HR = 1.94, p = 0.007), and GvHD relapse-free survival (HR = 2.38, p = 0.0002). CONCLUSIONS: Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM. SN - 1756-8722 UR - https://www.unboundmedicine.com/medline/citation/30165887/Haploidentical_transplantation_is_associated_with_better_overall_survival_when_compared_to_single_cord_blood_transplantation:_an_EBMT_Eurocord_study_of_acute_leukemia_patients_conditioned_with_thiotepa_busulfan_and_fludarabine_ L2 - https://jhoonline.biomedcentral.com/articles/10.1186/s13045-018-0655-8 DB - PRIME DP - Unbound Medicine ER -