Comparison of HLA-haploidentical donors with post-transplant cyclophosphamide versus HLA-matched unrelated donors in peripheral blood stem cell transplantation for acute myeloid leukaemia

被引：0

作者：

Moriguchi, Makoto ^{[1
]}

Nakamae, Hirohisa ^{[1
]}

Nishimoto, Mitsutaka ^{[1
]}

Sugita, Junichi ^{[2
]}

Yanada, Masamitsu ^{[3
]}

Toubai, Tomomi ^{[4
]}

Hasegawa, Yuta ^{[5
]}

Hino, Masayuki ^{[1
]}

Nishida, Tetsuya ^{[6
]}

Kurita, Naoki ^{[7
]}

Sawa, Masashi ^{[8
]}

Fukuda, Takahiro ^{[9
]}

Jinguji, Atsushi ^{[10
]}

Ota, Shuichi ^{[2
]}

Matsuoka, Ken-ichi ^{[11
]}

Eto, Tetsuya ^{[12
]}

Hiramoto, Nobuhiro ^{[13
]}

Ando, Toshihiko ^{[14
]}

Kawamura, Koji ^{[15
]}

Kanda, Yoshinobu ^{[16
]}

Atsuta, Yoshiko ^{[17
,18
]}

Ohbiki, Marie ^{[17
,18
,19
]}

Nakasone, Hideki ^{[20
,21
]}

Konuma, Takaaki ^{[22
]}

机构：

[1] Osaka Metropolitan Univ, Dept Hematol, Grad Sch Med, 1-4-3 Asahi Machi,Abeno Ku, Osaka 5458585, Japan

[2] Sapporo Hokuyu Hosp, Dept Hematol, Sapporo, Japan

[3] Nagoya City Univ, Dept Hematol & Oncol, East Med Ctr, Nagoya, Japan

[4] Yamagata Univ Hosp, Dept Hematol & Cell Therapy, Yamagata, Japan

[5] Hokkaido Univ Hosp, Dept Hematol, Sapporo, Japan

[6] Nagoya Daiichi Hosp, Japanese Red Cross Aichi Med Ctr, Dept Hematol, Nagoya, Japan

[7] Univ Tsukuba, Inst Med, Dept Hematol, Tsukuba, Japan

[8] Anjo Kosei Hosp, Dept Hematol & Oncol, Anjo, Japan

[9] Natl Canc Ctr, Hematopoiet Stem Cell Transplantat, Tokyo, Japan

[10] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Hematol Div, Tokyo, Japan

[11] Okayama Univ Hosp, Dept Hematol & Oncol, Okayama, Japan

[12] Hamanomachi Hosp, Dept Hematol, Fukuoka, Japan

[13] Kobe City Med Ctr, Gen Hosp, Dept Hematol, Kobe, Japan

[14] Saga Univ, Fac Med, Dept Internal Med, Div Hematol Resp Med & Oncol, Saga, Japan

[15] Tottori Univ, Dept Multidisciplinary Internal Med, Div Clin Lab Med, Yonago, Japan

[16] Jichi Med Univ, Div Hematol, Shimotsuke, Japan

[17] Japanese Data Ctr Hematopoiet Cell Transplantat, Nagakute, Japan

[18] Aichi Med Univ, Sch Med, Dept Registry Sci Transplant & Cellular Therapy, Nagakute, Japan

[19] Nagoya Univ, Grad Sch Med, Dept Hematol & Oncol, Nagoya, Japan

[20] Jichi Med Univ, Saitama Med Ctr, Div Hematol, Saitama, Japan

[21] Jichi Med Univ, Ctr Mol Med, Div Emerging Med Integrated Therapeut EMIT, Shimotsuke, Japan

[22] Univ Tokyo, Inst Med Sci, Dept Hematol Oncol, Tokyo, Japan

来源：

BRITISH JOURNAL OF HAEMATOLOGY | 2024年

关键词：

acute myeloid leukaemia; haploidentical donor; matched unrelated donor; peripheral blood stem cell transplantation; post-transplant cyclophosphamide; VERSUS-HOST-DISEASE; TRUMP DATA; OUTCOMES; SCRIPTS;

D O I：

10.1111/bjh.19825

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

HLA-haploidentical haematopoietic cell transplantation with post-transplant cyclophosphamide (PTCy-haplo) is emerging as an effective alternative due to donor availability and safety. We conducted a nationwide retrospective study comparing the outcomes of PTCy-haplo with both anti-thymocyte globulin (ATG)-free and ATG-administered matched unrelated donors (MUD) transplantation, using peripheral blood stem cells as the first transplantation for acute myeloid leukaemia (AML). Our study showed a lower and slower haematopoietic recovery and a higher incidence of infection-related deaths after PTCy-haplo than after MUD transplantation. In addition, we revealed an increased risk of acute and chronic graft-versus-host disease (GVHD) in ATG-free MUD transplantation in comparison to PTCy-haplo. For grades III-IV acute GVHD, the hazard ratio (HR) was 2.71 (95% CI, 1.46-5.01), and for extensive chronic GVHD, the HR was 3.11 (95% CI, 2.07-4.68). There was no significant difference regarding overall survival amongst the groups. In addition, GVHD-free relapse-free survival (GRFS) was lower in ATG-free MUD transplantation than in PTCy-haplo (HR, 1.46; 95% CI, 1.17-1.82). Notably, ATG-administered MUD transplantation showed no significant difference in GRFS from PTCy-haplo, negating the advantage of PTCy. Our results suggest that PTCy-haplo could be viable for AML patients without an HLA-matched related donor.

引用

页码：2376 / 2386

页数：11

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