Unmanipulated haploidentical stem cell transplantation in adults with acute lymphoblastic leukemia: a study on behalf of the Acute Leukemia Working Party of the EBMT

Abstract : AbstractBackgroundAllogenic hematopoietic stem cell transplantation (allo-SCT) is the most effective post-remission treatment for adults with high-risk acute lymphoblastic leukemia (ALL). The aim of the study was to analyze results of unmanipulated haploidentical allo-SCT (haplo-SCT) for adults with ALL and to identify prognostic factors.MethodsWe performed a retrospective analysis on 208 adults transplanted in EBMT centers from 2007 to 2014.ResultsMedian age at haplo-SCT was 32 years and median follow-up, 31 months. Forty-four percent of the patients were in first complete remission (CR1). Stem cell source was the bone marrow (BM) for 43% and peripheral blood (PB) for 57% of patients. Myeloablative conditioning (MAC) was used for 66% and reduced intensity regimen (RIC) for 34% of patients. GVHD prophylaxis was based on post-transplant cyclophosphamide (PT-Cy) for 118 (57%) or on anti-thymocyte-globulin (ATG) for 90 (43%) plus standard prophylaxis. One hundred eighty-four (92%) patients achieved engraftment. Cumulative incidence (CI) of grade II–IV acute-graft-versus-host-disease (GVHD) was 31%, grade III–IV 11%, and chronic GVHD 29%. Non-relapse mortality (NRM) and relapse-incidence (RI) were 32 and 37%, respectively. Overall survival (OS), leukemia-free survival (LFS), and GVHD-free, relapse-free-survival (GRFS) at 3 years were 33, 31, and 26%. For patients in CR1, OS, LFS, and GRFS were 52, 47, and 40%, respectively. Disease status was the main factor associated with transplant outcomes. Use of BM was independently associated with improvement in NRM, acute GVHD, GRFS, LFS, and OS.ConclusionsUnmanipulated haplo-SCT may be considered a valid option for adult patients with high-risk ALL lacking HLA identical donor preferably in early disease status.
Type de document :
Article dans une revue
Journal of Hematology and Oncology, BioMed Central, 2016, 10 (1), pp.113. 〈10.1186/s13045-017-0480-5〉
Liste complète des métadonnées

Littérature citée [45 références]  Voir  Masquer  Télécharger

http://www.hal.inserm.fr/inserm-01532896
Contributeur : Bmc Bmc <>
Soumis le : dimanche 4 juin 2017 - 05:42:09
Dernière modification le : mercredi 14 juin 2017 - 01:03:18
Document(s) archivé(s) le : mercredi 13 décembre 2017 - 09:43:14

Fichiers

13045_2017_Article_480.pdf
Publication financée par une institution

Identifiants

Collections

Citation

Nicole Santoro, Annalisa Ruggeri, Myriam Labopin, Andrea Bacigalupo, Fabio Ciceri, et al.. Unmanipulated haploidentical stem cell transplantation in adults with acute lymphoblastic leukemia: a study on behalf of the Acute Leukemia Working Party of the EBMT. Journal of Hematology and Oncology, BioMed Central, 2016, 10 (1), pp.113. 〈10.1186/s13045-017-0480-5〉. 〈inserm-01532896〉

Partager

Métriques

Consultations de la notice

16

Téléchargements de fichiers

60