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Post-transplantation cyclophosphamide after HLA identical compared to haploidentical donor transplant in acute myeloid leukemia: a study on behalf of GETH-TC

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Post-transplantation cyclophosphamide after HLA identical compared to haploidentical donor transplant in acute myeloid leukemia: a study on behalf of GETH-TC

dc.contributor.author	Bailen, Rebeca
dc.contributor.author	Pascual-Cascon, Maria Jesús.
dc.contributor.author	Guerreiro, Manuel
dc.contributor.author	Lopez-Corral, Lucia
dc.contributor.author	Chinea, Anabelle
dc.contributor.author	Bermudez, Arancha
dc.contributor.author	Sampol, Antonia
dc.contributor.author	Heras, Inmaculada
dc.contributor.author	Garcia-Torres, Estefanía
dc.contributor.author	Torres, Melissa
dc.contributor.author	Roca, José Rifón
dc.contributor.author	Herruzo, Beatriz
dc.contributor.author	Sanz, Jaime
dc.contributor.author	Fonseca, Marta
dc.contributor.author	Herrera, Pilar
dc.contributor.author	Colorado, Mercedes
dc.contributor.author	Bento, Leyre
dc.contributor.author	Lopez-Godino, Oriana
dc.contributor.author	Martin-Calvo, Carmen
dc.contributor.author	Fernandez-Caldas, Paula
dc.contributor.author	Marcos-Jubilar, Maria
dc.contributor.author	Sanchez-Ortega, Isabel
dc.contributor.author	Solano Vercet, Carlos
dc.contributor.author	Noriega, Victor
dc.contributor.author	Humala, Karem
dc.contributor.author	Oarbeascoa, Gillen
dc.contributor.author	Diez-Martin, Jose L.
dc.contributor.author	Kwon, Mi
dc.contributor.author	Grupo Español de Trasplante Hematopoyetico
dc.date.accessioned	2022-03-29T07:21:40Z
dc.date.available	2022-03-29T07:21:40Z
dc.date.issued	2022
dc.identifier.citation	Bailen, Rebeca Pascual-Cascon, Maria Jesús. Guerreiro, Manuel Lopez-Corral, Lucia Chinea, Anabelle Bermudez, Arancha Sampol, Antonia Heras, Inmaculada Garcia-Torres, Estefanía Torres, Melissa Roca, José Rifón Herruzo, Beatriz Sanz, Jaime Fonseca, Marta Herrera, Pilar Colorado, Mercedes Bento, Leyre Lopez-Godino, Oriana Martin-Calvo, Carmen Fernandez-Caldas, Paula Marcos-Jubilar, Maria Sanchez-Ortega, Isabel Solano Vercet, Carlos Noriega, Victor Humala, Karem Oarbeascoa, Gillen Diez-Martin, Jose L. Kwon, Mi Grupo Español de Trasplante Hematopoyetico 2022 Post-transplantation cyclophosphamide after HLA identical compared to haploidentical donor transplant in acute myeloid leukemia: a study on behalf of GETH-TC Transplantation and Cellular Therapy
dc.identifier.uri	https://hdl.handle.net/10550/82068
dc.description.abstract	Post-transplantation cyclophosphamide (PTCY) effectively prevents graft-versus-host disease (GVHD) after unmanipulated HLA-haploidentical hematopoietic stem cell transplantation (HSCT) and achieves low rates of GVHD in HLA-identical transplantation. To compare the outcomes of haploidentical versus HLA identical HSCT in patients undergoing HSCT for acute myeloid leukemia (AML) using PTCY. We conducted a retrospective study of 229 patients undergoing first HSCT for AML using PTCY with additional immunosuppression, 99 from matched sibling or unrelated donor (MSD/MUD) performed in 3 hospitals and 130 from haploidentical donors (haplo group) performed in 20 hospitals within the Spanish Group of Hematopoietic Stem Cell Transplantation and Cellular Therapy. Peripheral blood stem cells were used as graft in 89% of patients; myeloablative conditioning was used in 56%. There were significantly more patients with active disease (5% versus 20%, P = .001), high/very high disease risk index (DRI) (32% versus 67%, P = .000) and prior auto-HSCT (2% versus 11%, P = .010) in the haplo group. Median follow-up was 27 and 62.5 months for MSD/MUD and haplo, respectively. At 2 years, no significant differences were observed in overall survival (OS) (72% versus 62%, P = .07), event-free survival (EFS) (70% versus 54%, P = .055), cumulative incidence of relapse (19% versus 25%, P = .13), non-relapse mortality (14% versus 19%, P = .145), and the composite endpoint of GVHD and relapse-free survival (49% versus 42%, P = .249). Multivariate analysis identified only age and active disease as significant risk factors for OS and EFS; reduced-intensity conditioning, high/very high DRI, and haplo donor were nearly statistically significant for these outcomes. Grade II-IV acute GVHD was lower in MSD/MUD (14% versus 47%, P = .000). Cumulative incidences of grade III-IV acute GVHD (4% versus 9%, P = .14) and moderate-severe chronic GVHD (22% versus 19%, P = .28) were similar. Limitations of our study include limited sample size, differences between haplo and MSD/MUD groups and heterogeneous additional immunosuppression and PTCY timing in MSD/MUD. The use of an HLA-identical donor with PTCY in patients with AML showed lower incidence of clinically significant grade II-IV acute GVHD compared to haplo donors. Further studies with larger sample sizes should be performed to establish a possible benefit of HLA-identical donor on survival. (c) 2022 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
dc.language.iso	eng
dc.relation.ispartof	Transplantation and Cellular Therapy, 2022
dc.subject	Cèl·lules
dc.title	Post-transplantation cyclophosphamide after HLA identical compared to haploidentical donor transplant in acute myeloid leukemia: a study on behalf of GETH-TC
dc.type	journal article	es_ES
dc.date.updated	2022-03-29T07:21:40Z
dc.identifier.doi	10.1016/j.jtct.2022.01.020
dc.identifier.idgrec	150880
dc.rights.accessRights	open access	es_ES