Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia

被引：53

作者：

Wieduwilt, Matthew J. ^{[1
]}

Metheny, Leland ^{[2
]}

Zhang, Mei-Jie ^{[3
,4
]}

Wang, Hai-Lin ^{[3
]}

Estrada-Merly, Noel ^{[3
]}

Marks, David, I ^{[5
]}

Al-Homsi, A. Samer ^{[6
]}

Muffly, Lori ^{[7
]}

Chao, Nelson ^{[8
]}

Rizzieri, David ^{[9
]}

Gale, Robert Peter ^{[10
]}

Gadalla, Shahinaz M. ^{[11
]}

Cairo, Mitchell ^{[12
]}

Mussetti, Alberto ^{[13
,14
]}

Gore, Steven ^{[15
]}

Bhatt, Vijaya Raj ^{[16
]}

Patel, Sagar S. ^{[17
]}

Michelis, Fotios, V ^{[18
]}

Inamoto, Yoshihiro ^{[19
]}

Badawy, Sherif M. ^{[20
,21
]}

Copelan, Edward ^{[22
]}

Palmisiano, Neil ^{[23
]}

Kharfan-Dabaja, Mohamed A. ^{[24
]}

Lazarus, Hillard M. ^{[25
]}

Ganguly, Siddhartha ^{[26
]}

Bredeson, Christopher ^{[27
]}

Diaz Perez, Miguel Angel ^{[28
]}

Cassaday, Ryan ^{[29
]}

Savani, Bipin N. ^{[30
]}

Ballen, Karen ^{[31
]}

Martino, Rodrigo ^{[32
]}

Wirk, Baldeep ^{[33
]}

Bacher, Ulrike ^{[34
]}

Aljurf, Mahmoud ^{[35
]}

Bashey, Asad ^{[36
]}

Murthy, Hemant S. ^{[24
]}

Yared, Jean A. ^{[37
]}

Aldoss, Ibrahim ^{[38
]}

Farhadfar, Nosha ^{[39
]}

Liu, Hongtao ^{[40
]}

Abdel-Azim, Hisham ^{[41
]}

Waller, Edmund K. ^{[42
]}

Solh, Melhem ^{[43
]}

Seftel, Matthew D. ^{[44
]}

van der Poel, Marjolein ^{[45
]}

Grunwald, Michael R. ^{[22
]}

Liesveld, Jane L. ^{[46
]}

Kamble, Rammurti T. ^{[47
]}

McGuirk, Joseph ^{[26
]}

Munker, Reinhold ^{[48
]}

机构：

[1] Univ Oklahoma, Stephenson Canc Ctr, Oklahoma City, OK 73106 USA

[2] Univ Hosp Seidman Canc Ctr, Cleveland, OH USA

[3] Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA

[4] Med Coll Wisconsin, Inst Hlth & Equ, Div Biostat, Milwaukee, WI 53226 USA

[5] Univ Hosp Bristol Natl Hlth Serv Trust, Adult Bone Marrow Transplant, Bristol, Avon, England

[6] New York Univ Langone Hlth, New York, NY USA

[7] Stanford Univ, Div Blood & Marrow Transplantat, Stanford, CA 94305 USA

[8] Duke Univ, Med Ctr, Dept Med, Div Cell Therapy & Hematol, Durham, NC 27710 USA

[9] Duke Univ, Div Hematol Malignancies & Cellular Therapy, Durham, NC USA

[10] Imperial Coll London, Haematol Res Ctr, Dept Immunol & Inflammat, London, England

[11] NCI, Div Canc Epidemiol & Genet, Clin Genet Branch, NIH, Rockville, MD USA

[12] New York Med Coll, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, Valhalla, NY 10595 USA

[13] Inst Catala Oncol Hosp, Hematol Dept, Barcelona, Spain

[14] Inst Catala Oncol, Inst Invest Biomed Bellvitge, Lhospitalet De Llobregat, El Prat De Llob, Spain

[15] Yale New Haven Med Ctr, 20 York St, New Haven, CT 06504 USA

[16] Univ Nebraska Med Ctr, Fred & Pamela Buffett Canc Ctr, Omaha, NE USA

[17] Univ Utah, Huntsman Canc Inst, Blood & Marrow Transplant Program, Salt Lake City, UT USA

[18] Princess Margaret Canc Ctr, Allogene Blood & Marrow Transplant Program, Toronto, ON, Canada

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

[20] Ann & Robert H Lurie Childrens Hosp Chicago, Div Hematol Oncol & Stem Cell Transplant, Chicago, IL 60611 USA

[21] Northwestern Univ, Dept Pediat, Feinberg Sch Med, Chicago, IL 60611 USA

[22] Atrium Hlth, Dept Hematol Oncol & Blood Disorders, Levine Canc Inst, Charlotte, NC USA

[23] Thomas Jefferson Univ, Sidney Kimmel Canc Ctr, Philadelphia, PA 19107 USA

[24] Mayo Clin, Blood & Marrow Transplantat Program, Div Hematol Oncol, Jacksonville, FL 32224 USA

[25] Case Western Reserve Univ, Univ Hosp Cleveland, Med Ctr, Cleveland, OH 44106 USA

[26] Univ Kansas Hlth Syst, Div Hematol Malignancies & Cellular Therapeut, Kansas City, KS USA

[27] Ottawa Hosp, Transplant & Cellular Therapy Program, Ottawa, ON, Canada

[28] Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain

[29] Univ Washington, Fred Hutchinson Canc Res Ctr, Seattle, WA 98195 USA

[30] Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA

[31] Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA USA

[32] Hosp Santa Creu & Sant Pau, Div Clin Hematol, Barcelona, Spain

[33] Penn State Canc Inst, Bone Marrow Transplant Program, Hershey, PA USA

[34] Univ Bern, Bern Univ Hosp, Dept Hematol, Inselspital, Bern, Switzerland

[35] King Faisal Specialist Hosp Ctr & Res, Dept Oncol, Riyadh, Saudi Arabia

[36] Northside Hosp, Blood & Marrow Transplant Program, Atlanta, GA USA

[37] Univ Maryland, Dept Med, Greenebaum Comprehens Canc Ctr, Blood & Marrow Transplantat Program,Div Hematol O, Baltimore, MD 21201 USA

[38] City Hope Med Ctr, Duarte, CA USA

[39] Univ Florida, Div Hematol Oncol, Coll Med, Gainesville, FL USA

[40] Univ Chicago Med, Sect Hematol Oncol, Chicago, IL USA

[41] Univ Southern Calif, Childrens Hosp Los Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Keck Sch Med, Los Angeles, CA 90007 USA

[42] Emory Univ, Winship Canc Inst, Dept Hematol & Med Oncol, Atlanta, GA 30322 USA

[43] Northside Hosp, Blood & Marrow Transplant Grp Georgia, Atlanta, GA USA

[44] Univ British Columbia, Dept Med, Vancouver, BC, Canada

[45] Maastricht Univ, Med Ctr, Maastricht, Netherlands

[46] Univ Rochester, Med Ctr, Dept Med, Rochester, NY 14642 USA

[47] Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA

[48] Univ Kentucky, Markey Canc Ctr, Lexington, KY USA

[49] Univ Grenoble Alpes, Ctr Hosp Univ Grenoble Alpes, Dept Hematol, Grenoble, France

[50] Catholic Univ Korea, Div Hematol, Seoul St Marys Hosp, Seoul, South Korea

来源：

BLOOD ADVANCES | 2022年 / 6卷 / 01期

关键词：

MINIMAL RESIDUAL DISEASE; VERSUS-HOST-DISEASE; POSTTRANSPLANTATION CYCLOPHOSPHAMIDE; DONOR TRANSPLANTATION; GVHD PROPHYLAXIS; ADULT PATIENTS; RELAPSE; IMPACT; REMISSION; SURVIVAL;

D O I：

10.1182/bloodadvances.2021004916

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLAmatched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P <_ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P <_ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (<_18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

引用

页码：339 / 357

页数：19

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