Older MRD vs. younger MUD in patients older than 50 years with AML in remission using post-transplant cyclophosphamide.

Autor: Piemontese S; Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milan, Italy. piemontese.simona@hsr.it., Labopin M; EBMT Paris Office, Hopital Saint Antoine, Paris, France., Choi G; University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Broers AEC; Erasmus MC Cancer Institute - Rotterdam, Rotterdam, The Netherlands., Peccatori J; Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milan, Italy., Meijer E; Department of Hematology, Amsterdam UMC, location VU, Amsterdam, The Netherlands., Van Gorkom G; Department of Internal Medicine, Division of Hematology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands., Rovira M; BMT Unit, Haematology Department, Hospital Clinic, IDIBAPS and Josep Carreras Foundation, Barcelona, Spain., Pascual Cascon MJ; Hematology, Hospital Regional de Málaga, Malaga, Spain., Sica S; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy., Vydra J; Institute of Hematology and Blood Transfusion - Prague, Prague, Czech Republic., Kulagin A; RM Gorbacheva Research Institute, Pavlov University - Saint Petersburg, Saint Petersburg, Russian Federation., Spyridonidis A; Bone Marrow Transplantation and Institute of Cell Therapy, University of Patras, Patras, Greece., Nagler A; Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel., Bazarbachi A; Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon., Savani B; Department of Haematology-Oncology, Vanderbilt University, Medical Center, Nashville, TN, USA., Brissot E; Hôpital Saint-Antoine, Sorbonne University, INSERM UMRs, 938, Paris, France., Sanz J; Hospital Universitari i Politècnic La Fe, Hematology Department, Departament de Medicina Universitat de Valencia, Valencia, Spain., Mohty M; Hôpital Saint-Antoine, Sorbonne University, INSERM UMRs, 938, Paris, France., Ciceri F; Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milan, Italy.; Università Vita-Salute San Raffaele, Milan, Italy.
Jazyk: angličtina
Zdroj: Leukemia [Leukemia] 2024 Sep; Vol. 38 (9), pp. 2016-2022. Date of Electronic Publication: 2024 Jul 24.
DOI: 10.1038/s41375-024-02359-8
Abstrakt: An increasing number of older patients with acute myeloid leukemia (AML) are offered an allogeneic hematopoietic stem cell transplantation (allo-HSCT). Normally, older patients have older matched related donors (MRD). Matched unrelated donors (MUD) are an important alternative, but it remains unclear whether a younger MUD is associated with better outcomes, especially in the context of post-transplant cyclophosphamide (PTCy). We compared outcomes of patients older than 50 years with AML in first complete remission (CR1) and receiving a first HSCT from a 10/10 MUD aged younger than 40 years to those receiving a graft from a MRD aged older than 50 years, using PTCy and with well-known transplant conditioning intensity (TCI) score. A total of 345 consecutive patients were included and classified according to TCI score as low, intermediate, or high. On multivariable analysis in the TCI-intermediate/high group, MUD was associated with better graft-versus-host disease-free, relapse-free survival, lower non-relapse mortality and lower relapse incidence. For patients receiving a TCI-low regimen, outcomes are independent on the type of donor. In patients with AML in CR1, older than 50 years and receiving a TCI-intermediate/high conditioning regimen using PTCy, a MUD younger than 40 years is preferable over a MRD older than 50 years.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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