Haploidentical Bone Marrow Transplantation with Post-Transplant Cyclophosphamide Using Non–First-Degree Related Donors

Hany Elmariah, Yvette L. Kasamon, Marianna Zahurak, Karen W. Macfarlane, Noah Tucker, Gary L. Rosner, Javier Bolaños-Meade, Ephraim J. Fuchs, Nina Wagner-Johnston, Lode J. Swinnen, Carol Ann Huff, William H. Matsui, Douglas E. Gladstone, Shannon R. McCurdy, Ivan Borrello, Christian B. Gocke, Satish Shanbhag, Kenneth R. Cooke, Syed Abbas Ali, Robert A. BrodskyAmy E. DeZern, Leo Luznik, Richard J. Jones, Richard F. Ambinder

Research output: Contribution to journalArticlepeer-review

Abstract

Outcomes of nonmyeloablative (NMA) haploidentical (haplo) blood or marrow transplant (BMT) with post-transplantation cyclophosphamide (PTCy) using non–first-degree relatives are unknown. We evaluated 33 consecutive adult patients (median age, 56 years) with hematologic malignancies who underwent NMA haplo T cell–replete BMT with PTCy at Johns Hopkins using second- or third-degree related donors. Donors consisted of 10 nieces (30%), 9 nephews (27%), 7 first cousins (21%), 5 grandchildren (15%), and 2 uncles (6%). Thirty-one patients (94%) reached full donor chimerism by day 60. The estimated cumulative incidence (CuI) of grades II to IV acute graft-versus-host disease (aGVHD) at day 180 was 24% (90% confidence interval [CI], 9% to 38%). Only 1 patient experienced grades III to IV aGVHD. At 1 year the CuI of chronic GVHD was 10% (90% CI, 0% to 21%). The CuI of nonrelapse mortality at 1 year was 5% (90% CI, 0% to 14%). At 1 year the probability of relapse was 31% (90% CI, 12% to 49%), progression-free survival 64% (90% CI, 48% to 86%), and overall survival 95% (90% CI, 87% to 100%). The 1-year probability of GVHD-free, relapse-free survival was 57% (90% CI, 41% to 79%). NMA haplo BMT with PTCy from non–first-degree relatives is an acceptably safe and effective alternative donor platform, with results similar to those seen with first-degree relatives.

Original languageEnglish (US)
Pages (from-to)1099-1102
Number of pages4
JournalBiology of Blood and Marrow Transplantation
Volume24
Issue number5
DOIs
StatePublished - May 2018

Keywords

  • Bone marrow transplant
  • Haploidentical
  • Post-transplant cyclophosphamide
  • Second-degree relatives

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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