TY - JOUR
T1 - Reduced-intensity transplantation for lymphomas using haploidentical related donors vs HLA-matched unrelated donors
AU - Kanate, Abraham S.
AU - Mussetti, Alberto
AU - Kharfan-Dabaja, Mohamed A.
AU - Ahn, Kwang W.
AU - Digilio, Alyssa
AU - Beitinjaneh, Amer
AU - Chhabra, Saurabh
AU - Fenske, Timothy S.
AU - Freytes, Cesar
AU - Gale, Robert Peter
AU - Ganguly, Siddhartha
AU - Hertzberg, Mark
AU - Klyuchnikov, Evgeny
AU - Lazarus, Hillard M.
AU - Olsson, Richard
AU - Perales, Miguel Angel
AU - Rezvani, Andrew
AU - Riches, Marcie
AU - Saad, Ayman
AU - Slavin, Shimon
AU - Smith, Sonali M.
AU - Sureda, Anna
AU - Yared, Jean
AU - Ciurea, Stefan
AU - Armand, Philippe
AU - Salit, Rachel
AU - Bolaños-Meade, Javier
AU - Hamadani, Mehdi
N1 - Publisher Copyright:
© 2016 by The American Society of Hematology.
PY - 2016/2/18
Y1 - 2016/2/18
N2 - We evaluated 917 adult lymphoma patients who received haploidentical (n 5 185) or HLAmatched unrelated donor (URD) transplantation either with (n 5 241) or without antithymocyte globulin (ATG; n 5 491) following reduced-intensity conditioning regimens. Haploidentical recipients received posttransplant cyclophosphamide-based graft-versushost disease (GVHD) prophylaxis, whereas URD recipients received calcineurin inhibitorbased prophylaxis. Median follow-up of survivors was 3 years. The 100-day cumulative incidence of grade III-IV acute GVHD on univariate analysis was 8%, 12%, and 17% in the haploidentical, URD without ATG, and URD with ATG groups, respectively (P 5 .44). Corresponding 1-year rates of chronic GVHD on univariate analysis were 13%, 51%, and 33%, respectively (P < .001).Onmultivariate analysis, grade III-IV acuteGVHDwas higher in URD without ATG (P 5 .001), as well as URD with ATG (P 5 .01), relative to haploidentical transplants. Similarly, relative to haploidentical transplants, risk of chronic GVHD was higher in URDwithout ATGandURD withATG(P < .0001). Cumulative incidence of relapse/ progression at 3 years was 36%, 28%, and 36%in the haploidentical,URDwithout ATG, and URD with ATG groups, respectively (P 5 .07). Corresponding 3-year overall survival (OS) was 60%, 62%, and 50% in the 3 groups, respectively, withmultivariate analysis showing no survival difference between URD without ATG (P 5 .21) or URD with ATG (P 5 .16), relative to haploidentical transplants.Multivariate analysis showed no difference between the 3 groups in terms of nonrelapsemortality (NRM), relapse/progression, and progression-free survival (PFS). These data suggest that reduced-intensity conditioning haploidentical transplantation with posttransplant cyclophosphamide does not compromise early survival outcomes compared with matched URD transplantation, and is associated with significantly reduced risk of chronic GVHD. (Blood. 2016;127(7):938-947).
AB - We evaluated 917 adult lymphoma patients who received haploidentical (n 5 185) or HLAmatched unrelated donor (URD) transplantation either with (n 5 241) or without antithymocyte globulin (ATG; n 5 491) following reduced-intensity conditioning regimens. Haploidentical recipients received posttransplant cyclophosphamide-based graft-versushost disease (GVHD) prophylaxis, whereas URD recipients received calcineurin inhibitorbased prophylaxis. Median follow-up of survivors was 3 years. The 100-day cumulative incidence of grade III-IV acute GVHD on univariate analysis was 8%, 12%, and 17% in the haploidentical, URD without ATG, and URD with ATG groups, respectively (P 5 .44). Corresponding 1-year rates of chronic GVHD on univariate analysis were 13%, 51%, and 33%, respectively (P < .001).Onmultivariate analysis, grade III-IV acuteGVHDwas higher in URD without ATG (P 5 .001), as well as URD with ATG (P 5 .01), relative to haploidentical transplants. Similarly, relative to haploidentical transplants, risk of chronic GVHD was higher in URDwithout ATGandURD withATG(P < .0001). Cumulative incidence of relapse/ progression at 3 years was 36%, 28%, and 36%in the haploidentical,URDwithout ATG, and URD with ATG groups, respectively (P 5 .07). Corresponding 3-year overall survival (OS) was 60%, 62%, and 50% in the 3 groups, respectively, withmultivariate analysis showing no survival difference between URD without ATG (P 5 .21) or URD with ATG (P 5 .16), relative to haploidentical transplants.Multivariate analysis showed no difference between the 3 groups in terms of nonrelapsemortality (NRM), relapse/progression, and progression-free survival (PFS). These data suggest that reduced-intensity conditioning haploidentical transplantation with posttransplant cyclophosphamide does not compromise early survival outcomes compared with matched URD transplantation, and is associated with significantly reduced risk of chronic GVHD. (Blood. 2016;127(7):938-947).
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U2 - 10.1182/blood-2015-09-671834
DO - 10.1182/blood-2015-09-671834
M3 - Article
C2 - 26670632
AN - SCOPUS:84959378642
SN - 0006-4971
VL - 127
SP - 938
EP - 947
JO - Blood
JF - Blood
IS - 7
ER -