Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia.

Szczegóły
Abstrakt

Tytuł:: Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia.
Autorzy:: Nagler A; Division of Hematology, Chaim Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel.; EBMT ALWP Office, Saint Antoine Hospital, Paris, France.
Dholaria B; Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA. .
Labopin M; Department of Haematology and EBMT Paris Study Office/CEREST-TC, Saint Antoine Hospital, Paris, France.
Savani BN; Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA.
Angelucci E; Hematology and Transplant Center, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Koc Y; Medicana International, Istanbul, Turkey.
Arat M; Hematopoietic SCT Unit, Florence Nightingale Sisli Hospital, Istanbul, Turkey.
Pioltelli P; Ospedale San Gerardo, Clinica Ematologica dell'Universita Milano-Biocca, Monza, Italy.
Sica S; Divisione di Ematologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy.
Gülbas Z; Bone Marrow Transplantation Department, Anadolu Medical Center Hospital, Kocaeli, Turkey.
Tischer J; Klinikum Grosshadern, Med. Klinik III, Munich, Germany.
Bernasconi P; BMT Unit, Clinica Ematologica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Pavlu J; Department of Haematology, Hammersmith Hospital, Imperial College, London, UK.
Socié G; Dept. of Hematology-BMT, Hospital St. Louis, Paris, France.
Blaise D; Programme de Transplantation&Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France.
Rigacci L; Dept. of Hematology and BMT, Ospedale S. Camillo-Forlanini, Rome, Italy.
Martino M; Grande Ospedale Metropolitano Bianchi Melacrino Morelli, Centro Unico Trapianti A. Neri, Alberto Neri, Bianchi-Melacrino-Morelli, Reggio Calabri, Italy.
Diez-Martin JL; Department of Hematology, Hospital GU Gregorio Marañon, Instituto de Investigación Sanitaria Gregorio Marañon' Universidad Complutense Medicina, Madrid, Spain.
Perić Z; Dept.of Internal Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia.
Giebel S; Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute-Oncology Center, Gliwice Branch, Gliwice, Poland.
Mohty M; EBMT ALWP Office, Saint Antoine Hospital, Paris, France.; Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Sorbonne University, and INSERM UMRs 938, Paris, France.
Źródło:: Leukemia [Leukemia] 2020 Oct; Vol. 34 (10), pp. 2766-2775. Date of Electronic Publication: 2020 May 11.
Typ publikacji:: Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Publication: 2000- : London : Nature Publishing Group, Specialist Journals
Original Publication: [Baltimore, Md.] : Williams & Wilkins, [c1987-
MeSH Terms:: Bone Marrow Transplantation*/adverse effects
Bone Marrow Transplantation*/methods
Hematopoietic Stem Cell Mobilization*
Lymphocyte Depletion*
Peripheral Blood Stem Cell Transplantation*/adverse effects
Peripheral Blood Stem Cell Transplantation*/methods
Transplantation, Haploidentical*
Precursor Cell Lymphoblastic Leukemia-Lymphoma/*therapy
Cause of Death ; Combined Modality Therapy ; Female ; Graft vs Host Disease/diagnosis ; Graft vs Host Disease/etiology ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality ; Proportional Hazards Models ; T-Lymphocytes ; Transplantation Conditioning/methods ; Treatment Outcome
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Entry Date(s):: Date Created: 20200513 Date Completed: 20201130 Latest Revision: 20210209
Update Code:: 20240105
DOI:: 10.1038/s41375-020-0850-9
PMID:: 32393841
: Czasopismo naukowe

The ideal stem cell graft source remains unknown in haploidentical haematopietic cell transplantation (haplo-HCT) with posttransplantation cyclophosphamide (PTCy). This study compared outcomes of bone marrow (BM) versus peripheral blood (PB) stem cell graft for haplo-HCT in acute lymphoblastic leukemia (ALL). A total of 314 patients with ALL (BM-157; PB-157) were included in this study. The cumulative incidence of engraftment at day 30 was higher in the PB group compared with BM (93% vs. 88%, p < 0.01). The incidences of acute graft-versus-host disease (GVHD) and chronic GVHD were not significantly different between the study cohorts. In the multivariate analysis, there were tendencies toward a higher incidence of grade II-IV acute GVHD (hazard ratio (HR) = 1.52, p = 0.07), chronic GVHD (HR = 1.58, p = 0.05), and nonrelapse mortality (NRM) (HR = 1.66, p = 0.06) in patients receiving PB versus BM graft, respectively. The use of PB grafts was associated with lower leukemia-free survival (LFS) (HR = 1.43, p = 0.05), overall survival (OS) (HR = 1.59, p = 0.02), and GVHD-free, relapse-free survival (GRFS) (HR = 1.42, p = 0.03) compared with BM grafts. There was no difference in relapse incidence (HR = 1.23, p = 0.41) between the study groups. In conclusion, use of BM graft results in better survival after haplo-HCT with PTCy in patients with ALL, compared with PB stem cell graft.

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