Impact of total body irradiation- vs chemotherapy-based myeloablative conditioning on outcomes of haploidentical hematopoietic cell transplantation for acute myelogenous leukemia

被引：11

作者：

Dholaria, Bhagirathbhai ^{[1
]}

Labopin, Myriam ^{[2
,3
]}

Angelucci, Emanuele ^{[4
]}

Ciceri, Fabio ^{[5
]}

Diez-Martin, Jose L. ^{[6
]}

Bruno, Benedetto ^{[7
]}

Sica, Simona ^{[8
]}

Koc, Yener ^{[9
]}

Gulbas, Zafer ^{[10
]}

Schmid, Christoph ^{[11
]}

Blaise, Didier ^{[12
]}

Carella, Angelo Michele ^{[13
]}

Visani, Guiseppe ^{[14
]}

Savani, Bipin N. ^{[1
]}

Nagler, Arnon ^{[15
]}

Mohty, Mohamad ^{[3
,16
]}

机构：

[1] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[2] St Antoine Hosp, INSERM, UMR 938, Paris, France

[3] CEREST TC, EBMT Paris Study Off, Paris, France

[4] IRCCS Osped Policlin San Martino, Ematol & Ctr Trapianti, Genoa, Italy

[5] Osped San Raffaele Srl, Haematol & BMT, Milan, Italy

[6] Univ Complutense, Inst Invest Sanitaria Gregorio Maranon, Hosp GU Gregorio Maranon, Madrid, Spain

[7] AOU Citta Salute & Sci Torino, SSCVD Trapianto Cellule Staminali, Presidio Molinette, Turin, Italy

[8] Univ Cattolica S Cuore, Ist Ematol, Rome, Italy

[9] Med Int, Istanbul, Turkey

[10] Anadolu Med Ctr Hosp, Bone Marrow Transplantat Dept, Kocaeli, Turkey

[11] Univ Klinikum Augsburg, Dept Hematol & Oncol, Augsburg, Germany

[12] Inst Paoli Calmettes, Ctr Rech Cancerol Marseille, Programme Transplantat & Therapie Cellulaire, Marseille, France

[13] Casa Sollievo Sofferenza, IRCCS, Stem Cell Transplant Unit, Dept Hematol Oncol, San Giovanni Rotondo, Italy

[14] AORMN Hosp, Hematol & Transplant Ctr, Pesaro, Italy

[15] Hop St Antoine, Chaim Sheba Med Ctr, Tel Hashomer Israel & ALWP Off, Paris, France

[16] Univ Paris 06, INSERM, St Antoine Hosp, UMR 938, Paris, France

来源：

AMERICAN JOURNAL OF HEMATOLOGY | 2020年 / 95卷 / 10期

关键词：

BONE-MARROW-TRANSPLANTATION; ACUTE MYELOID-LEUKEMIA; 1ST COMPLETE REMISSION; REDUCED-INTENSITY; POSTTRANSPLANTATION CYCLOPHOSPHAMIDE; PREPARATIVE REGIMEN; RANDOMIZED-TRIAL; EUROPEAN GROUP; BUSULFAN-CYTOXAN; WORKING PARTY;

D O I：

10.1002/ajh.25934

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The optimal myeloablative conditioning (MAC) for patients undergoing haploidentical hematopoietic cell transplantation (haplo-HCT) is unknown. We studied the outcomes of total body irradiation (TBI) vs chemotherapy (CT) based MAC regimens in acute myeloid leukemia (AML) patients. The study included 1008 patients who underwent first haplo-HCT with post-transplant cyclophosphamide, following TBI (N = 89, 9%) or CT (n = 919, 91%) based MAC. Patients in the TBI cohort were younger (median age, 38 vs 47 years,P< .01) and more likely to receive BM graft (57% vs 43%, P=.01). Two-year overall chronic GVHD (cGVHD) incidence was 42% vs 27% (P< .01) and extensive cGVHD incidence was 9% vs 12% (P= .33) in TBI and CT cohorts, respectively. Graft failure was reported in two (2%) TBI- and 65 (7%) CT-MAC recipients (P= .08). Death from veno-occlusive disease was reported in one (3%) TBI and 11 (3%) CT patients who died during the study period. In the multivariate analysis, TBI was associated with increased risk for overall cGVHD (hazard ratio = 1.95, 95% confidence interval:1.2-3.1, P<.01) compared to CT-based MAC. The choice of conditioning regimen did not impact relapse incidence, leukemia-free survival, non-relapse mortality, overall survival or GVHD-relapse-free survival in multivariate analysis. In conclusion, major transplant outcomes were not statistically different between TBI-based MAC and CT-based MAC in patients with AML after haplo-HCT/PTCy.

引用

页码：1200 / 1208

页数：9

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