Haploidentical Versus Matched Sibling Donor Hematopoietic Stem Cell Transplantation for Adult Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia: A Study From the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. - Université de Lille Accéder directement au contenu
Article Dans Une Revue HemaSphere Année : 2022

Haploidentical Versus Matched Sibling Donor Hematopoietic Stem Cell Transplantation for Adult Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia: A Study From the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.

A. Nagler
  • Fonction : Auteur
R. Swoboda
  • Fonction : Auteur
P. Pioltelli
  • Fonction : Auteur
M. Arat
  • Fonction : Auteur
A. Kulagin
  • Fonction : Auteur
A. Maria Raiola
  • Fonction : Auteur
H. Ozdogu
  • Fonction : Auteur
A. Risitano
  • Fonction : Auteur
Z. Nur Ozkurt
  • Fonction : Auteur
J. Sanz
  • Fonction : Auteur
P. Zina
  • Fonction : Auteur
S. Giebel
  • Fonction : Auteur
F. Ciceri
  • Fonction : Auteur

Résumé

The results of haploidentical stem cell transplantation (haploHCT) for patients with acute lymphoblastic leukemia (ALL) transplanted in active disease remain largely unknown. We retrospectively analyzed adult patients with R/R ALL who underwent haploHCT or matched sibling donor (MSD-HCT) as a first transplantation between 2012 and 2020. The analysis comprised 274 patients, 94 had a haploHCT, and 180 had an MSD-HCT. The median follow-up was 32 months. The median age was 33 (range 18–76) and 37 (18–76) years in the haplo- and MSD-HCT groups, respectively. Post-transplant cyclophosphamide (PTCy) was used in 88% of haploHCT and in 4% of the MSD-HCT group. Graft-versus-host disease grade III–IV was higher in haploHCT than in the MSD-HCT group (18% versus 9%; P = 0.042). The 2-year chronic (c) graft-versus-host disease rates were 17% versus 33% (hazard ratio [HR] = 0.56; P = 0.14), respectively. By multivariate analysis, relapse incidence, and leukemia-free survival were not significatively different between the transplant groups, while nonrelapse mortality (NRM) was significantly higher (25% versus 18% at 2 years; HR = 2.03; P = 0.042) and overall survival (OS) lower (22% versus 38% at 2 years; HR = 1.72; P = 0.009) in the haploHCT group compared with the MSD-HCT group. We conclude that the 2-year OS of R/R ALL patients undergoing MSD transplants is significantly better than in haploHCT with a higher NRM in the latter.
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Dates et versions

hal-04504414 , version 1 (14-03-2024)

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Paternité - Pas d'utilisation commerciale - Pas de modification

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A. Nagler, Myriam Labopin, R. Swoboda, P. Pioltelli, M. Arat, et al.. Haploidentical Versus Matched Sibling Donor Hematopoietic Stem Cell Transplantation for Adult Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia: A Study From the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.. HemaSphere, 2022, HemaSphere, 6, pp.e790. ⟨10.1097/HS9.0000000000000790⟩. ⟨hal-04504414⟩
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