Young (<35 years) haploidentical versus old (≥35 years) mismatched unrelated donors and vice versa for allogeneic stem cell transplantation with post-transplant cyclophosphamide in patients with acute myeloid leukemia in first remission: a study on behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.

Autor: Nagler A; Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel. arnon.nagler@sheba.health.gov.il., Labopin M; Department of Hematology, EBMT Paris Study Office, Saint Antoine Hospital, INSERM UMR 938, Sorbonne University, Paris, France.; Department of Hematology, Saint Antoine Hospital, INSERM UMR 938, Sorbonne University, Paris, France., Swoboda R; Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland., Blaise D; Programme de Transplantation & Therapie Cellulaire, Marseille, France., Angelucci E; Ospedale San Raffaele s.r.l., Milano, Italy., Vydra J; Institute of Hematology and Blood Transfusion, Prague, Czech Republic., Corral LL; Hospital Clínico, Salamanca, Spain., Bramanti S; Transplantation Unit Department of Oncology and Haematology, IRCCS Humanitas Research Hospital, Milan, Italy., Chiusolo P; Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy., Kwon M; Department of Hematology, Hospital General Universitario Gregorio Marañon, Institute of Health Research Gregorio Marañon, Madrid, Spain., Koc Y; Medicana International Hospital Istanbul, Istanbul, Turkey., Itäla-Remes M; Turku University Hospital, Turku, Finland., Martino M; Stem Cell Transplantation and Cellular Therapies Unit (CTMO), Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano 'Bianchi-Melacrino-Morelli', Reggio Calabria, Italy., Kulagin A; RM Gorbacheva Research Institute, Pavlov University, Petersburg, Russian Federation., Busca A; S.S.C.V. D Trapianto di Cellule Staminali, Torino, Italy., Ciceri F; IRCCS Osspedale San Raffaele, Vita-Salute San Raffaele University Hematology and BMT, Milano, Italy., Mohty M; Department of Hematology, EBMT Paris Study Office, Saint Antoine Hospital, INSERM UMR 938, Sorbonne University, Paris, France.; Department of Hematology, Saint Antoine Hospital, INSERM UMR 938, Sorbonne University, Paris, France.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2024 Nov; Vol. 59 (11), pp. 1552-1562. Date of Electronic Publication: 2024 Aug 18.
DOI: 10.1038/s41409-024-02400-5
Abstrakt: We compared transplantation (HSCT) outcomes in AML patients undergoing HSCT with post-transplant cyclophosphamide (PTCy) in first complete remission from 1065 young (<35 years) haploidentical (Haplo) donors (yHaplo) vs. 147 old (≥35 years) mismatched unrelated donors (oMMUD) (first comparison) and from 271 young (<35 years) MMUD (yMMUD) vs. 1315 old (≥35 years) Haplo donors (oHaplo) (second comparison). Acute graft-versus-host disease (aGVHD) grades II-IV were significantly lower in the yHaplo vs. oMMUD group (HR = 0.62, p = 0.007). There were no significant differences in chronic GVHD, non-relapse mortality (NRM), relapse incidence, leukemia-free survival, overall survival, and GVHD-free and relapse-free survival. As for the second comparison, more patients in the oHaplo group had de novo AML, 86.6% vs. 81.9% in the yMMUD group (p = 0.044), while myeloablative conditioning was used more frequently in the yMMUD group, 53.3% vs. 46.8% in the oHaplo group (p = 0.049). aGVHD grades II-IV and NRM were significantly lower in the yMMUD vs. oHaplo group (HR = 0.69, p = 0.013 and HR = 0.60, p = 0.022). All other transplant outcomes did not differ. In conclusion, HSCT from young alternative donors (<35 years) results in a lower incidence of grades II-IV aGVHD. In addition, NRM is lower in HSCT from yMMUD compared to HSCT from oHaplo.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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