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Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia.
Leukemia. 2020 May 11 [Online ahead of print]L

Abstract

The ideal stem cell graft source remains unknown in haploidentical haematopietic cell transplantation (haplo-HCT) with posttransplantation cyclophosphamide (PTCy). This study compared outcomes of bone marrow (BM) versus peripheral blood (PB) stem cell graft for haplo-HCT in acute lymphoblastic leukemia (ALL). A total of 314 patients with ALL (BM-157; PB-157) were included in this study. The cumulative incidence of engraftment at day 30 was higher in the PB group compared with BM (93% vs. 88%, p < 0.01). The incidences of acute graft-versus-host disease (GVHD) and chronic GVHD were not significantly different between the study cohorts. In the multivariate analysis, there were tendencies toward a higher incidence of grade II-IV acute GVHD (hazard ratio (HR) = 1.52, p = 0.07), chronic GVHD (HR = 1.58, p = 0.05), and nonrelapse mortality (NRM) (HR = 1.66, p = 0.06) in patients receiving PB versus BM graft, respectively. The use of PB grafts was associated with lower leukemia-free survival (LFS) (HR = 1.43, p = 0.05), overall survival (OS) (HR = 1.59, p = 0.02), and GVHD-free, relapse-free survival (GRFS) (HR = 1.42, p = 0.03) compared with BM grafts. There was no difference in relapse incidence (HR = 1.23, p = 0.41) between the study groups. In conclusion, use of BM graft results in better survival after haplo-HCT with PTCy in patients with ALL, compared with PB stem cell graft.

Authors+Show Affiliations

Division of Hematology, Chaim Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel. EBMT ALWP Office, Saint Antoine Hospital, Paris, France.Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA. Bhagirathbhai.R.Dholaria@vumc.org.Department of Haematology and EBMT Paris Study Office/CEREST-TC, Saint Antoine Hospital, Paris, France.Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.Hematology and Transplant Center, IRCCS Ospedale Policlinico San Martino, Genova, Italy.Medicana International, Istanbul, Turkey.Hematopoietic SCT Unit, Florence Nightingale Sisli Hospital, Istanbul, Turkey.Ospedale San Gerardo, Clinica Ematologica dell'Universita Milano-Biocca, Monza, Italy.Divisione di Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy.Bone Marrow Transplantation Department, Anadolu Medical Center Hospital, Kocaeli, Turkey.Klinikum Grosshadern, Med. Klinik III, Munich, Germany.BMT Unit, Clinica Ematologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.Department of Haematology, Hammersmith Hospital, Imperial College, London, UK.Dept. of Hematology-BMT, Hospital St. Louis, Paris, France.Programme de Transplantation&Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France.Dept. of Hematology and BMT, Ospedale S. Camillo-Forlanini, Rome, Italy.Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Centro Unico Trapianti A. Neri, Alberto Neri, Bianchi-Melacrino-Morelli, Reggio Calabri, Italy.Department of Hematology, Hospital GU Gregorio Marañon, Instituto de Investigación Sanitaria Gregorio Marañon' Universidad Complutense Medicina, Madrid, Spain.Dept.of Internal Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia.Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute-Oncology Center, Gliwice Branch, Gliwice, Poland.EBMT ALWP Office, Saint Antoine Hospital, Paris, France. Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne University, and INSERM UMRs 938, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32393841

Citation

Nagler, Arnon, et al. "Bone Marrow Versus Mobilized Peripheral Blood Stem Cell Graft in T-cell-replete Haploidentical Transplantation in Acute Lymphoblastic Leukemia." Leukemia, 2020.
Nagler A, Dholaria B, Labopin M, et al. Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia. Leukemia. 2020.
Nagler, A., Dholaria, B., Labopin, M., Savani, B. N., Angelucci, E., Koc, Y., Arat, M., Pioltelli, P., Sica, S., Gülbas, Z., Tischer, J., Bernasconi, P., Pavlu, J., Socié, G., Blaise, D., Rigacci, L., Martino, M., Diez-Martin, J. L., Perić, Z., ... Mohty, M. (2020). Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia. Leukemia. https://doi.org/10.1038/s41375-020-0850-9
Nagler A, et al. Bone Marrow Versus Mobilized Peripheral Blood Stem Cell Graft in T-cell-replete Haploidentical Transplantation in Acute Lymphoblastic Leukemia. Leukemia. 2020 May 11; PubMed PMID: 32393841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia. AU - Nagler,Arnon, AU - Dholaria,Bhagirathbhai, AU - Labopin,Myriam, AU - Savani,Bipin N, AU - Angelucci,Emanuele, AU - Koc,Yener, AU - Arat,Mutlu, AU - Pioltelli,Pietro, AU - Sica,Simona, AU - Gülbas,Zafer, AU - Tischer,Johanna, AU - Bernasconi,Paolo, AU - Pavlu,Jiri, AU - Socié,Gerard, AU - Blaise,Didier, AU - Rigacci,Luigi, AU - Martino,Massimo, AU - Diez-Martin,Jose Luis, AU - Perić,Zinaida, AU - Giebel,Sebastian, AU - Mohty,Mohamad, Y1 - 2020/05/11/ PY - 2019/12/26/received PY - 2020/04/27/accepted PY - 2020/04/23/revised PY - 2020/5/13/entrez JF - Leukemia JO - Leukemia N2 - The ideal stem cell graft source remains unknown in haploidentical haematopietic cell transplantation (haplo-HCT) with posttransplantation cyclophosphamide (PTCy). This study compared outcomes of bone marrow (BM) versus peripheral blood (PB) stem cell graft for haplo-HCT in acute lymphoblastic leukemia (ALL). A total of 314 patients with ALL (BM-157; PB-157) were included in this study. The cumulative incidence of engraftment at day 30 was higher in the PB group compared with BM (93% vs. 88%, p < 0.01). The incidences of acute graft-versus-host disease (GVHD) and chronic GVHD were not significantly different between the study cohorts. In the multivariate analysis, there were tendencies toward a higher incidence of grade II-IV acute GVHD (hazard ratio (HR) = 1.52, p = 0.07), chronic GVHD (HR = 1.58, p = 0.05), and nonrelapse mortality (NRM) (HR = 1.66, p = 0.06) in patients receiving PB versus BM graft, respectively. The use of PB grafts was associated with lower leukemia-free survival (LFS) (HR = 1.43, p = 0.05), overall survival (OS) (HR = 1.59, p = 0.02), and GVHD-free, relapse-free survival (GRFS) (HR = 1.42, p = 0.03) compared with BM grafts. There was no difference in relapse incidence (HR = 1.23, p = 0.41) between the study groups. In conclusion, use of BM graft results in better survival after haplo-HCT with PTCy in patients with ALL, compared with PB stem cell graft. SN - 1476-5551 UR - https://www.unboundmedicine.com/medline/citation/32393841/Bone_marrow_versus_mobilized_peripheral_blood_stem_cell_graft_in_T-cell-replete_haploidentical_transplantation_in_acute_lymphoblastic_leukemia L2 - http://dx.doi.org/10.1038/s41375-020-0850-9 DB - PRIME DP - Unbound Medicine ER -
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