TY - JOUR
T1 - PTCy-based haploidentical vs matched related or unrelated donor reduced-intensity conditioning transplant for DLBCL
AU - Dreger, Peter
AU - Sureda, Anna
AU - Ahn, Kwang Woo
AU - Eapen, Mary
AU - Litovich, Carlos
AU - Finel, Herve
AU - Boumendil, Ariane
AU - Gopal, Ajay
AU - Herrera, Alex F.
AU - Schmid, Christoph
AU - Diez-Martin, José Luis
AU - Fuchs, Ephraim
AU - Bolaños-Meade, Javier
AU - Gooptu, Mahasweta
AU - Al Malki, Monzr M.
AU - Castagna, Luca
AU - Ciurea, Stefan O.
AU - Dominietto, Alida
AU - Blaise, Didier
AU - Ciceri, Fabio
AU - Tischer, Johanna
AU - Corradini, Paolo
AU - Montoto, Silvia
AU - Robinson, Stephen
AU - Gülbas, Zafer
AU - Hamadani, Mehdi
N1 - Publisher Copyright:
© 2019 by The American Society of Hematology
PY - 2019/2/12
Y1 - 2019/2/12
N2 - This study retrospectively compared long-term outcomes of nonmyeloablative/reduced intensity conditioning (NMC/RIC) allogeneic hematopoietic cell transplantation (allo-HCT) from a haploidentical family donor (haplo-HCT) using posttransplant cyclophosphamide (PTCy) with those of matched sibling donor (MSD) and matched unrelated donor (MUD) with or without T-cell depletion (TCD1/TCD2) in patients with relapsed diffuse large B-cell lymphoma (DLBCL). Adult patients with DLBCL who had undergone their first NMC/RIC allo-HCT between 2008 and 2015 were included. Recipients of haplo-HCT were limited to those receiving graft-versus-host disease (GVHD) prophylaxis with PTCy. GVHD prophylaxis in MSD was limited to calcineurin inhibitor (CNI)–based approaches without in vivo TCD, while MUD recipients received CNI-based prophylaxis with or without TCD. Outcome analyses for overall survival (OS) and progression-free survival (PFS), nonrelapse mortality (NRM), and disease relapse/progression were calculated. A total of 1438 patients (haplo, 132; MSD, 525; MUD TCD1, 403; and MUD TCD2, 378) were included. Patients with haplo donors were significantly older, had a better performance status and had more frequently received total body irradiation-based conditioning regimens and bone marrow grafts than MSD and MUD TCD1 or TCD2. 3-year OS, PFS, NRM and relapse/progression incidence after haplo-HCT was 46%, 38%, 22%, and 41%, respectively, and not significantly different from outcomes of matched donor transplants on multivariate analyses. Haplo-HCT was associated with a lower cumulative incidence of chronic GVHD compared with MSD, MUD TCD1/TCD2. NMC/RIC haplo-HCT with PTCy seems to be a valuable alternative for patients with DLBCL considered for allo-HCT but lacking a matched donor.
AB - This study retrospectively compared long-term outcomes of nonmyeloablative/reduced intensity conditioning (NMC/RIC) allogeneic hematopoietic cell transplantation (allo-HCT) from a haploidentical family donor (haplo-HCT) using posttransplant cyclophosphamide (PTCy) with those of matched sibling donor (MSD) and matched unrelated donor (MUD) with or without T-cell depletion (TCD1/TCD2) in patients with relapsed diffuse large B-cell lymphoma (DLBCL). Adult patients with DLBCL who had undergone their first NMC/RIC allo-HCT between 2008 and 2015 were included. Recipients of haplo-HCT were limited to those receiving graft-versus-host disease (GVHD) prophylaxis with PTCy. GVHD prophylaxis in MSD was limited to calcineurin inhibitor (CNI)–based approaches without in vivo TCD, while MUD recipients received CNI-based prophylaxis with or without TCD. Outcome analyses for overall survival (OS) and progression-free survival (PFS), nonrelapse mortality (NRM), and disease relapse/progression were calculated. A total of 1438 patients (haplo, 132; MSD, 525; MUD TCD1, 403; and MUD TCD2, 378) were included. Patients with haplo donors were significantly older, had a better performance status and had more frequently received total body irradiation-based conditioning regimens and bone marrow grafts than MSD and MUD TCD1 or TCD2. 3-year OS, PFS, NRM and relapse/progression incidence after haplo-HCT was 46%, 38%, 22%, and 41%, respectively, and not significantly different from outcomes of matched donor transplants on multivariate analyses. Haplo-HCT was associated with a lower cumulative incidence of chronic GVHD compared with MSD, MUD TCD1/TCD2. NMC/RIC haplo-HCT with PTCy seems to be a valuable alternative for patients with DLBCL considered for allo-HCT but lacking a matched donor.
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UR - http://www.scopus.com/inward/citedby.url?scp=85061139017&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2018027748
DO - 10.1182/bloodadvances.2018027748
M3 - Article
C2 - 30723110
AN - SCOPUS:85061139017
SN - 2473-9529
VL - 3
SP - 360
EP - 369
JO - Blood Advances
JF - Blood Advances
IS - 3
ER -