TY - JOUR
T1 - Reduced-intensity transplantation for lymphomas using haploidentical related donors versus HLA-matched sibling donors
T2 - A center for international blood and marrow transplant research analysis
AU - Ghosh, Nilanjan
AU - Karmali, Reem
AU - Rocha, Vanderson
AU - Ahn, Kwang Woo
AU - DiGilio, Alyssa
AU - Hari, Parameswaran N.
AU - Bachanova, Veronika
AU - Bacher, Ulrike
AU - Dahi, Parastoo
AU - De Lima, Marcos
AU - D'Souza, Anita
AU - Fenske, Timothy S.
AU - Ganguly, Siddhartha
AU - Kharfan-Dabaja, Mohamed A.
AU - Prestidge, Tim D.
AU - Savani, Bipin N.
AU - Smith, Sonali M.
AU - Sureda, Anna M.
AU - Waller, Edmund K.
AU - Jaglowski, Samantha
AU - Herrera, Alex F.
AU - Armand, Philippe
AU - Salit, Rachel B.
AU - Wagner-Johnston, Nina D.
AU - Fuchs, Ephraim
AU - Bolaños-Meade, Javier
AU - Hamadani, Mehdi
N1 - Publisher Copyright:
© 2016 by American Society of Clinical Oncology.
PY - 2016/9/10
Y1 - 2016/9/10
N2 - Purpose: Related donor haploidentical hematopoietic cell transplantation (Haplo-HCT) using post-transplantation cyclophosphamide (PT-Cy) is increasingly used in patients lacking HLA-matched sibling donors (MSD). We compared outcomes after Haplo-HCT using PT-Cy with MSD-HCT in patients with lymphoma, using the Center for International Blood and Marrow Transplant Research registry. Materials and Methods: We evaluated 987 adult patients undergoing either Haplo-HCT (n = 180) or MSD-HCT (n = 807) following reduced-intensity conditioning regimens. The haploidentical group received graft-versushost disease (GVHD) prophylaxis with PT-Cy with or without a calcineurin inhibitor and mycophenolate. The MSD group received calcineurin inhibitor-based GVHD prophylaxis. Results: Median follow-up of survivors was 3 years. The 28-day neutrophil recovery was similar in the two groups (95% v 97%; P = .31). The 28-day platelet recovery was delayed in the haploidentical group compared with the MSD group (63% v 91%; P = .001). Cumulative incidence of grade II to IV acute GVHD at day 100 was similar between the two groups (27% v 25%; P = .84). Cumulative incidence of chronic GVHD at 1 year was significantly lower after Haplo-HCT (12% v 45%; P < .001), and this benefit was confirmed on multivariate analysis (relative risk, 0.21; 95% CI, 0.14 to 0.31; P < .001). For Haplo-HCT v MSD-HCT, 3-year rates of nonrelapse mortality (15% v 13%; P = .41), relapse/progression (37% v 40%; P = .51), progression-free survival (48% v 48%; P = .96), and overall survival (61% v 62%; P = .82) were similar. Multivariate analysis showed no significant difference between Haplo-HCT and MSD-HCT in terms of nonrelapse mortality (P = .06), progression/relapse (P = .10), progression-free survival (P = .83), and overall survival (P = .34). Conclusion: Haplo-HCT with PT-Cy provides survival outcomes comparable to MSD-HCT, with a significantly lower risk of chronic GVHD.
AB - Purpose: Related donor haploidentical hematopoietic cell transplantation (Haplo-HCT) using post-transplantation cyclophosphamide (PT-Cy) is increasingly used in patients lacking HLA-matched sibling donors (MSD). We compared outcomes after Haplo-HCT using PT-Cy with MSD-HCT in patients with lymphoma, using the Center for International Blood and Marrow Transplant Research registry. Materials and Methods: We evaluated 987 adult patients undergoing either Haplo-HCT (n = 180) or MSD-HCT (n = 807) following reduced-intensity conditioning regimens. The haploidentical group received graft-versushost disease (GVHD) prophylaxis with PT-Cy with or without a calcineurin inhibitor and mycophenolate. The MSD group received calcineurin inhibitor-based GVHD prophylaxis. Results: Median follow-up of survivors was 3 years. The 28-day neutrophil recovery was similar in the two groups (95% v 97%; P = .31). The 28-day platelet recovery was delayed in the haploidentical group compared with the MSD group (63% v 91%; P = .001). Cumulative incidence of grade II to IV acute GVHD at day 100 was similar between the two groups (27% v 25%; P = .84). Cumulative incidence of chronic GVHD at 1 year was significantly lower after Haplo-HCT (12% v 45%; P < .001), and this benefit was confirmed on multivariate analysis (relative risk, 0.21; 95% CI, 0.14 to 0.31; P < .001). For Haplo-HCT v MSD-HCT, 3-year rates of nonrelapse mortality (15% v 13%; P = .41), relapse/progression (37% v 40%; P = .51), progression-free survival (48% v 48%; P = .96), and overall survival (61% v 62%; P = .82) were similar. Multivariate analysis showed no significant difference between Haplo-HCT and MSD-HCT in terms of nonrelapse mortality (P = .06), progression/relapse (P = .10), progression-free survival (P = .83), and overall survival (P = .34). Conclusion: Haplo-HCT with PT-Cy provides survival outcomes comparable to MSD-HCT, with a significantly lower risk of chronic GVHD.
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U2 - 10.1200/JCO.2015.66.3476
DO - 10.1200/JCO.2015.66.3476
M3 - Article
C2 - 27269951
AN - SCOPUS:84989838395
SN - 0732-183X
VL - 34
SP - 3141
EP - 3149
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 26
ER -