TY - JOUR
T1 - Allogeneic Haploidentical Blood or Marrow Transplantation with Post-Transplantation Cyclophosphamide in Chronic Lymphocytic Leukemia
AU - Paul, Suman
AU - Tsai, Hua Ling
AU - Lowery, Patrick
AU - Fuchs, Ephraim J.
AU - Luznik, Leo
AU - Bolaños-Meade, Javier
AU - Swinnen, Lode J.
AU - Shanbhag, Satish
AU - Wagner-Johnston, Nina
AU - Varadhan, Ravi
AU - Ambinder, Richard F.
AU - Jones, Richard J.
AU - Gladstone, Douglas E.
N1 - Funding Information:
The authors thank the nurses, physicians, bone marrow transplantation service members, transplantation coordinator's office, and staff at the cell therapy laboratory for the exceptional clinical care they provided. Financial disclosure: This study was supported by the National Institutes of Health, National Cancer Institute grants P01 CA015396 and P30 CA06973 (to R.J.J.). Conflict of interest statement : There are no conflicts of interest to report. Authorship statement: S.P. and D.E.G. conceptualized the study, collected data, and wrote the manuscript. P.L. collected data and maintained the patient database. H.T. and R.V. performed statistical analyses. L.J.S., S.S., N.W.J., R.A.B., and D.E.G. contributed patients, collected and analyzed data. E.F., L.L., J.B.-M., R.A.B., and R.J.J. formulated important aspects of the BMT platform used in the study and revised the manuscript.
Publisher Copyright:
© 2019
PY - 2020/3
Y1 - 2020/3
N2 - Allogeneic blood or marrow transplantation (allo-BMT) remains the only treatment for chronic lymphocytic leukemia (CLL) with curative potential. Although post-transplantation cyclophosphamide (PTCy) reduces allo-BMT toxicity by decreasing the risk of graft-versus-host disease (GVHD), its effect on CLL allo-BMT outcomes is unknown. We studied 64 consecutive patients with CLL who underwent nonmyeloablative (NMA) haploidentical allo-BMT at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. In this cohort, the 4-year overall survival was 52% (95% confidence interval [CI], 40% to 68%), and progression-free survival was 37% (95% CI, 26% to 54%). Six patients experienced engraftment failure. PTCy prophylaxis was associated with a modest cumulative incidence of 1-year grade II-IV acute GVHD (27%; %95% CI, 15% to 38%) and %%%2-year chronic GVHD (17%; 95% CI, 7% to 26%). We demonstrate that NMA haploidentical allo-BMT with PTCy is a safe and effective treatment option.
AB - Allogeneic blood or marrow transplantation (allo-BMT) remains the only treatment for chronic lymphocytic leukemia (CLL) with curative potential. Although post-transplantation cyclophosphamide (PTCy) reduces allo-BMT toxicity by decreasing the risk of graft-versus-host disease (GVHD), its effect on CLL allo-BMT outcomes is unknown. We studied 64 consecutive patients with CLL who underwent nonmyeloablative (NMA) haploidentical allo-BMT at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. In this cohort, the 4-year overall survival was 52% (95% confidence interval [CI], 40% to 68%), and progression-free survival was 37% (95% CI, 26% to 54%). Six patients experienced engraftment failure. PTCy prophylaxis was associated with a modest cumulative incidence of 1-year grade II-IV acute GVHD (27%; %95% CI, 15% to 38%) and %%%2-year chronic GVHD (17%; 95% CI, 7% to 26%). We demonstrate that NMA haploidentical allo-BMT with PTCy is a safe and effective treatment option.
KW - Allogeneic blood or marrow transplantation
KW - Chronic lymphocytic leukemia
KW - Graft-versus-host-disease
KW - Haploidentical
KW - Post-transplantation cyclophosphamide
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U2 - 10.1016/j.bbmt.2019.11.008
DO - 10.1016/j.bbmt.2019.11.008
M3 - Article
C2 - 31730920
AN - SCOPUS:85076556779
VL - 26
SP - 502
EP - 508
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
IS - 3
ER -