Search

Background: Three different scoring systems have been developed to assess pre‐transplant comorbidity in allogeneic hematopoietic stem cell transplantation (Allo‐HSCT): the Hematopoietic Cell Transplantation‐Specific Comorbidity Index, the Comorbidity/Age index, and the Augmented Comorbidity/Age index. All were devised to predict overall survival (OS) and disease‐free survival (DFS) survivals and non‐relapse mortality (NRM) in patients receiving HLA‐matched Allo‐HSCT, but their performance has scarcely been studied in the haploidentical Allo‐HSCT setting with post‐transplant cyclophosphamide, a procedure in constant expansion worldwide. Methods: To address this issue, their impact on survivals and NRM was examined in a cohort of 223 patients treated with haploidentical Allo‐HSCT in four different centers. Results: With a median follow‐up of 35.6 months, 3‐year OS, DFS, and NRM were 48.1% ± 4%, 46.3% ± 4%, and 30.0% ± 3%, respectively. No impact was found for any of the three comorbidity scores in univariate analysis. In multivariate analyses, the only three factors associated with lower OS were DRI (p < 0.001), an older age of recipients (≥55 years old, p = 0.02) and of donors (≥40 years old, p = 0.005). Older donor age was also associated with lower DFS and higher NRM. Conclusion: The comorbidity scores do not predict survivals nor NRM in haploidentical Allo‐HSCT with PTCY, suggesting that pre‐transplant comorbidities should not be a contra‐indication to this procedure. [ABSTRACT FROM AUTHOR]

Graft-versus host disease (GVHD) remains one of the main causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (ASCT). Prophylactic T cell depletion via antithymocyte globulin (ATG) during ASCT conditioning is one of the standards of care for GVHD prophylaxis, although the optimal dosing strategy is still unclear. Recent studies have reported that absolute lymphocyte count at the time of ATG administration could predict survivals in ASCT from unrelated donors. Here this issue was examined in 116 patients receiving peripheral blood stem cells (PBSC) ASCT with purine analog/busulfan-based conditioning regimens between 2009 and 2019 in our department. The impact of lymphopenia at the time of ATG administration was evaluated in terms of overall survival, disease-free survival and GVHD-free/relapse-free survival. After a median follow-up of 4 years, no adverse effect of a profound lymphopenia was observed on patients' outcome. Notably, a reduced dose of ATG in patients with profound lymphopenia did not translate into better survivals. This study indicates that ATG can be administered whatever the recipient's lymphocyte counts in patients receiving a PBSC purine analog/busulfan-based conditioning regimen ASCT. [ABSTRACT FROM AUTHOR]

Finally, the proportion of patients documented twice with the highest antibody level at SpV2 and SpV2+/SpV3 was similar between V3- and V3+ patients (50% vs. 60%, I P i = 0-55). Vaccine, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mRNA, coronavirus disease 2019 (COVID-19), allogeneic haematopoietic stem cell transplantation, BNT162b2, third dose Keywords: coronavirus disease 2019 (COVID-19); vaccine; allogeneic haematopoietic stem cell transplantation; BNT162b2; severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mRNA; third dose EN coronavirus disease 2019 (COVID-19) vaccine allogeneic haematopoietic stem cell transplantation BNT162b2 severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mRNA third dose e38 e40 3 02/28/22 20220301 NES 220301 The efficacy of two doses of anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) messenger RNA (mRNA) vaccines, successfully demonstrated in healthy populations,1 is progressively reported in recipients of allogeneic haematopoietic stem cell transplant (allo-HSCT) with, surprisingly, high humoral antibody responses of ~80%.1-3 In our own experience based on an observational study of 117 allo-HSCT adult recipients, we found that 83% of them achieved a significant specific humoral response after two doses (V1 and V2) of BNT162b2 anti-SARS-CoV-2 mRNA vaccine (Pfizer BioNTech). [Extracted from the article]