Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation: An EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine

Giannotti, F.; Labopin, M.; Shouval, R.; Sanz, J.; Arcese, W.; Angelucci, E.; Sierra, J.; Santasusana, J.-M. R.; Santarone, S.; Benedetto, B.; Rambaldi, A.; Saccardi, R.; Blaise, D.; Carella, M. A.; Rocha, V.; Baron, Frédéric; Mohty, M.; Ruggeri, A.; Nagler, A.

doi:10.1186/s13045-018-0655-8

Article (Scientific journals)

Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation: An EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine

Giannotti, F.; Labopin, M.; Shouval, R. et al.

2018 • In Journal of Hematology and Oncology, 11 (1), p. 110

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https://hdl.handle.net/2268/234788

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10.1186/s13045-018-0655-8

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30165887

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Keywords :

Acute myeloid leukemia; Conditioning regimens; Haploidentical stem cell transplantation; Stem cell transplantation; Thiotepa-busulfan-fludarabine; Umbilical cord blood transplantation

Abstract :

[en] Background: Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established. Methods: This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics. Results: SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1.03, p = 0.92 or HR = 1.86, p = 0.21) and relapse incidence (HR = 0.8, p = 0.65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2.63, p = 0.001); moreover, SUCBT did worse in terms of overall survival (HR = 2.18, p = 0.002), leukemia-free survival (HR = 1.94, p = 0.007), and GvHD relapse-free survival (HR = 2.38, p = 0.0002). Conclusions: Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM. © 2018 The Author(s).

Disciplines :

Hematology

Author, co-author :

Giannotti, F.; Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France

Labopin, M.; Department of Hematology and Cell Therapy, Saint-Antoine Hospital, Paris, France, Acute Leukemia Working Party EBMT Paris Office, Hospital Saint- Antoine, Paris, France

Shouval, R.; Division of Hematology, Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Ramat-Gan, 52621, Israel, Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel

Sanz, J.; Hospital Universitari y Politecnic la Fe, Valencia, Spain, Instituto Carlos III, CIBERONC, Madrid, Spain

Arcese, W.; Rome Transplant Network tor Vergatä, University of Rome, Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy

Angelucci, E.; Hematology and Transplant Unit, Ospedale Policlinico San Martino, Genoa, Italy

Sierra, J.; Hematology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain

Santasusana, J.-M. R.; ICO-Hospital Universitari Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain

Santarone, S.; Ospedale Civile, Dipartimento di Ematologia, Medicina Trasfusionale e Biotecnologie, Pescara, Italy

Benedetto, B.; S.S.C.V.D Trapianto di Cellule Staminali A.O.U Citta della Salute e della Scienza di Torino, Torino, Italy

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Language :

English

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Publication date :

2018

Journal title :

Journal of Hematology and Oncology

eISSN :

1756-8722

Publisher :

BioMed Central Ltd.

Volume :

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Pages :

110

Peer reviewed :

Peer Reviewed verified by ORBi

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