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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
- 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.
- Subjects :
- Adult
Male
medicine.medical_specialty
T cell replete
Lymphoblastic Leukemia
T-Lymphocytes
Population
Graft vs Host Disease
[SDV.CAN]Life Sciences [q-bio]/Cancer
Human leukocyte antigen
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Clinical endpoint
Humans
education
ComputingMilieux_MISCELLANEOUS
Retrospective Studies
Transplantation
Acute leukemia
education.field_of_study
Hematopoietic cell
business.industry
Hematopoietic Stem Cell Transplantation
Hematology
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia, Myeloid, Acute
medicine.anatomical_structure
[SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology
030220 oncology & carcinogenesis
Bone marrow
business
Unrelated Donors
030215 immunology
Subjects
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⟩