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Comparing outcomes of a second allogeneic hematopoietic cell transplant using HLA-matched unrelated versus T-cell replete haploidentical donors in relapsed acute lymphoblastic leukemia: a study of the Acute Leukemia Working Party of EBMT

Comparing outcomes of a second allogeneic hematopoietic cell transplant using HLA-matched unrelated versus T-cell replete haploidentical donors in relapsed acute lymphoblastic leukemia: a study of the Acute Leukemia Working Party of EBMT

Authors :
Johanna Tischer
Arne Brecht
Tobias Gedde-Dahl
Thomas Valerius
Eolia Brissot
Didier Blaise
Mohamad Mohty
Mohamed A. Kharfan-Dabaja
Bipin N. Savani
Arnon Nagler
Jürgen Kuball
Annalisa Ruggeri
José Luis Díez-Martín
Fabio Benedetti
Tsila Zuckerman
Emanuele Angelucci
Christoph Schmid
Sebastian Giebel
Hélène Labussière-Wallet
Dolores Caballero
Martin Bornhäuser
Jaime Sanz
Victoria T Potter
Ali Bazarbachi
Benedetto Bruno
Myriam Labopin
Fabio Ciceri
Jürgen Finke
Riitta Niittyvuopio
Kharfan-Dabaja, M. A.
Labopin, M.
Bazarbachi, A.
Ciceri, F.
Finke, J.
Bruno, B.
Bornhauser, M.
Gedde-Dahl, T.
Labussiere-Wallet, H.
Niittyvuopio, R.
Valerius, T.
Angelucci, E.
Brecht, A.
Caballero, D.
Kuball, J.
Potter, V.
Schmid, C.
Tischer, J.
Zuckerman, T.
Benedetti, F.
Blaise, D.
Diez-Martin, J. L.
Sanz, J.
Ruggeri, A.
Brissot, E.
Savani, B. N.
Giebel, S.
Nagler, A.
Mohty, M.
Institut Paoli-Calmettes
Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)
Centre de Recherche en Cancérologie de Marseille (CRCM)
Aix Marseille Université (AMU)-Institut Paoli-Calmettes
Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Source :
BONE MARROW TRANSPLANTATION, r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe, instname, Bone Marrow Transplantation, Bone Marrow Transplantation, 2021, 56 (9), pp.2194-2202. ⟨10.1038/s41409-021-01317-7⟩
Publication Year :
2020

Abstract

Optimal donor choice for a second allogeneic hematopoietic cell transplant (allo-HCT) in relapsed acute lymphoblastic leukemia (ALL) remains undefined. We compared outcomes using HLA-matched unrelated donors (MUD) versus haploidentical donors in this population. Primary endpoint was overall survival (OS). The MUD allo-HCT group comprised 104 patients (male = 56, 54%), median age 36 years, mostly (76%) with B-cell phenotype in complete remission (CR) (CR2/CR3 + = 76, 73%). The 61 patients (male = 38, 62%) in the haploidentical group were younger, median age 30 years (p = 0.002), had mostly (79%) a B-cell phenotype and the majority were also in CR at time of the second allo-HCT (CR2/CR3 + = 40, 66%). Peripheral blood stem cells was the most common cell source in both, but a significantly higher number in the haploidentical group received bone marrow cells (26% vs. 4%, p < 0.0001). A haploidentical donor second allo-HCT had a 1.5-fold higher 2-year OS (49% vs. 31%), albeit not statistically significant (p = 0.13). A longer time from first allo-HCT to relapse was associated with improved OS, leukemia-free survival, graft-versus-host disease-free-relapse-free survival, and lower cumulative incidences of relapse and non-relapse mortality. Results suggest no major OS difference when choosing either a MUD or haploidentical donor for ALL patients needing a second allo-HCT.

Details

ISSN :
14765365 and 02683369
Volume :
56
Issue :
9
Database :
OpenAIRE
Journal :
Bone marrow transplantation
Accession number :
edsair.doi.dedup.....494384a33ff9a9ea2d66902a64ebb73d
Full Text :
https://doi.org/10.1038/s41409-021-01317-7⟩