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Bone marrow versus mobilized peripheral blood stem cells in haploidentical transplants using posttransplantation cyclophosphamide
Cancer, 2018-04, Vol.124 (7), p.1428-1437
Ruggeri, Annalisa
Labopin, Myriam
Bacigalupo, Andrea
Gülbas, Zafer
Koc, Yener
Blaise, Didier
Bruno, Benedetto
Irrera, Giuseppe
Tischer, Johanna
Diez‐Martin, Jose Luiz
Castagna, Luca
Ciceri, Fabio
Mohty, Mohamad
Nagler, Arnon
2018
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Ruggeri, Annalisa
Labopin, Myriam
Bacigalupo, Andrea
Gülbas, Zafer
Koc, Yener
Blaise, Didier
Bruno, Benedetto
Irrera, Giuseppe
Tischer, Johanna
Diez‐Martin, Jose Luiz
Castagna, Luca
Ciceri, Fabio
Mohty, Mohamad
Nagler, Arnon
Titel
Bone marrow versus mobilized peripheral blood stem cells in haploidentical transplants using posttransplantation cyclophosphamide
Ist Teil von
Cancer, 2018-04, Vol.124 (7), p.1428-1437
Ort / Verlag
United States: Wiley Subscription Services, Inc
Erscheinungsjahr
2018
Quelle
MEDLINE
Beschreibungen/Notizen
BACKGROUND Incidence of graft‐versus‐host disease (GVHD) in haploidentical bone marrow (BM) transplants using posttransplantion cyclophosphamide (PT‐Cy) is low, whereas GVHD using mobilized peripheral blood stem cells (PBSC) ranges between 30% and 40%. METHODS To evaluate the effect of stem cell source in haploidentical transplantation with PT‐Cy, we analyzed 451 patients transplanted for acute myeloid leukemia or acute lymphoblastic leukemia reported to the European Society for Blood and Marrow Transplantation. RESULTS BM was used in 260 patients, and PBSC were used in 191 patients. The median follow‐up was 21 months. Engraftment was lower in BM (92% vs 95%, P < 0.001). BM was associated with a lower incidence of stage II‐IV and stage III‐IV acute GVHD (21% vs 38%, P ≤ .01; and 4% vs 14%, P < .01, respectively). No difference in chronic GVHD, relapse, or nonrelapse mortality were found for PBSC or BM. The 2‐year overall survival (OS) was 55% versus 56% (P = .57) and leukemia‐free survival (LFS) was 49% versus 54% (P = .74) for BM and PBSC, respectively. On multivariate analysis, PBSC were associated with an increased risk of stage II‐IV (hazard ratio [HR], 2.1; P < .001) and stage III‐IV acute GVHD (HR, 3.8; P < .001). For LFS and OS, reduced intensity conditioning was the only factor associated with treatment failure (LFS: HR, 1.40; P = .04) and relapse (HR, 1.62; P = .02). CONCLUSION In patients with acute leukemia in first or second remission receiving haploidentical transplantation with PT‐Cy, the use of PBSC increases the risk of acute GVHD, whereas survival outcomes are comparable. Cancer 2018;124:1428‐37. © 2018 American Cancer Society. For patients with acute leukemia in complete remission, the use of peripheral blood stem cells (PBSC) significantly increases the risk of acute graft‐versus‐host disease (GVHD) compared with bone marrow (BM) in haploidentical transplantation with posttransplantion cyclophosphamide (PT‐Cy). Chronic GVHD and survival outcomes are comparable in PBSC versus BM recipients in haploidentical transplantation with PT‐Cy.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X
eISSN: 1097-0142
DOI: 10.1002/cncr.31228
Titel-ID: cdi_proquest_miscellaneous_1990493303
Format
–
Schlagworte
acute graft‐versus‐host disease
,
acute leukemia
,
Acute lymphoblastic leukemia
,
Acute myeloid leukemia
,
Adolescent
,
Adult
,
Aged
,
Blood
,
Bone marrow
,
Bone marrow transplantation
,
Bone Marrow Transplantation - mortality
,
Cancer
,
Combined Modality Therapy
,
Cyclophosphamide
,
Cyclophosphamide - therapeutic use
,
Female
,
Follow-Up Studies
,
Graft vs Host Disease - mortality
,
Graft vs Host Disease - prevention & control
,
Graft-versus-host reaction
,
haploidentical transplantation
,
Hematopoietic stem cells
,
Humans
,
Incidence
,
Leukemia
,
Leukemia, Myeloid, Acute - immunology
,
Leukemia, Myeloid, Acute - pathology
,
Leukemia, Myeloid, Acute - therapy
,
Lymphatic leukemia
,
Male
,
Middle Aged
,
Multivariate analysis
,
Myeloablative Agonists - therapeutic use
,
Myeloid leukemia
,
Oncology
,
Patients
,
Peripheral blood
,
Peripheral Blood Stem Cell Transplantation - mortality
,
posttransplantation cyclophosphamide
,
Precursor Cell Lymphoblastic Leukemia-Lymphoma - immunology
,
Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology
,
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
,
Prognosis
,
Remission
,
Retrospective Studies
,
stem cell source
,
Stem cells
,
Survival
,
Survival Rate
,
Transplantation
,
Transplantation Conditioning
,
Transplantation, Haploidentical
,
Transplants
,
Transplants & implants
,
Young Adult
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