Haploidentical transplant in adult patients with acute lymphoblastic leukemia in Argentina: a comparison with matched related and unrelated donors.

Autor: Basquiera AL; Hospital Italiano de Buenos Aires, CABA, Buenos Aires, Argentina. ana.basquiera@hospitalitaliano.org.ar., Berro M; Hospital Universitario Austral, Pilar, Buenos Aires, Argentina., Yantorno S; Hospital Italiano de La Plata, Plata, Buenos Aires, Argentina., Castro M; Sanatorio Anchorena, CABA, Buenos Aires, Argentina., Requejo A; Fundacion Favaloro, CABA, Buenos Aires, Argentina., Sorrentino M; Sanatorio Sagrado Corazón, CABA, Buenos Aires, Argentina., Sutovsky D; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina., Giunta D; Hospital Italiano de Buenos Aires, CABA, Buenos Aires, Argentina., Palmer S; Hospital Británico, CABA, Buenos Aires, Argentina., Vitriu A; Instituto Alexander Fleming, CABA, Buenos Aires, Argentina., Ferini G; Hospital Italiano de Buenos Aires, CABA, Buenos Aires, Argentina., Bendek G; Hospital Italiano de San Justo, San Justo, Buenos Aires, Argentina., Szelagowski M; Hospital Italiano de La Plata, Plata, Buenos Aires, Argentina., Rapán ML; Sanatorio Sagrado Corazón, CABA, Buenos Aires, Argentina., Escobar NF; Fundacion Favaloro, CABA, Buenos Aires, Argentina., Duarte P; CEMIC, CABA, Buenos Aires, Argentina., Cerutti A; Centro de Hematología y Trasplante de Rosario, Rosario, Argentina., Cattaneo M; CETRAMOR, Rosario, Argentina., Martinez-Rolón J; FUNDALEU, CABA, Buenos Aires, Argentina., Jaimovich G; Fundacion Favaloro, CABA, Buenos Aires, Argentina., Bordone J; Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina., Milovic V; Hospital Alemán, CABA, Buenos Aires, Argentina., Kusminsky G; Hospital Universitario Austral, Pilar, Buenos Aires, Argentina., Arbelbide JA; Hospital Italiano de Buenos Aires, CABA, Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2020 Feb; Vol. 55 (2), pp. 400-408. Date of Electronic Publication: 2019 Sep 24.
DOI: 10.1038/s41409-019-0687-x
Abstrakt: We aimed at analyzing the outcome of allogeneic stem cell transplant (ASCT) in adult patients with acute lymphoblastic leukemia (ALL), comparing Haploidentical (Haplo) with HLA-matched (sibling and unrelated) donors. Between 2008 and 2017, we collected data from 236 patients (median age 31 years; range 16-64; 90% HCT-CI 0-1) who underwent unmanipulated ASCT in first complete remission and subsequent remissions in 15 Argentinian centers. Donors were HLA-matched (n = 175; 74%) and Haplo (n = 61; 26%). Two-year overall survival (OS) was 55% (95% CI 47-63) for the HLA-matched group and 49% (95% CI 34-62) for the Haplo group (p = 0.351). For OS, crude HR, adjusted HR for covariates (HR 1.24; 95% CI 0.77-1.99; p = 0.363) and HR including a propensity score in the model (HR 1.22; 95% CI 0.71-2.08; p = 0.414) showed no impact of donor category on the OS. No difference was found in terms of nonrelapse mortality, relapse, leukemia-free survival, and grade 3-4 acute graft-versus-host disease (GVHD); 2-year incidence of chronic GVHD was higher in HLA-matched vs Haplo group (p = 0.028). Patients with ALL who underwent ASCT were young subjects with low HCT-CI. In this setting, a Haplo donor represents an alternative widely available in the absence of an HLA-matched donor. Relapse remains a challenge for all donor categories.
Databáze: MEDLINE
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