Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia

Arnon Nagler, Bhagirathbhai Dholaria, Myriam Labopin, Bipin N. Savani, Emanuele Angelucci, Yener Koc, Mutlu Arat, Pietro Pioltelli, Simona Sica, Zafer Gülbas, Johanna Tischer, Paolo Bernasconi, Jiri Pavlu, Gerard Socié, Didier Blaise, Luigi Rigacci, Massimo Martino, Jose Luis Diez-Martin, Zinaida Perić, Sebastian GiebelMohamad Mohty

Research output: Contribution to journalArticle

Abstract

The ideal stem cell graft source remains unknown in haploidentical haematopietic cell transplantation (haplo-HCT) with posttransplantation cyclophosphamide (PTCy). This study compared outcomes of bone marrow (BM) versus peripheral blood (PB) stem cell graft for haplo-HCT in acute lymphoblastic leukemia (ALL). A total of 314 patients with ALL (BM—157; PB—157) were included in this study. The cumulative incidence of engraftment at day 30 was higher in the PB group compared with BM (93% vs. 88%, p < 0.01). The incidences of acute graft-versus-host disease (GVHD) and chronic GVHD were not significantly different between the study cohorts. In the multivariate analysis, there were tendencies toward a higher incidence of grade II–IV acute GVHD (hazard ratio (HR) = 1.52, p = 0.07), chronic GVHD (HR = 1.58, p = 0.05), and nonrelapse mortality (NRM) (HR = 1.66, p = 0.06) in patients receiving PB versus BM graft, respectively. The use of PB grafts was associated with lower leukemia-free survival (LFS) (HR = 1.43, p = 0.05), overall survival (OS) (HR = 1.59, p = 0.02), and GVHD-free, relapse-free survival (GRFS) (HR = 1.42, p = 0.03) compared with BM grafts. There was no difference in relapse incidence (HR = 1.23, p = 0.41) between the study groups. In conclusion, use of BM graft results in better survival after haplo-HCT with PTCy in patients with ALL, compared with PB stem cell graft.

Original languageEnglish
JournalLeukemia
DOIs
Publication statusAccepted/In press - Jan 1 2020

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Nagler, A., Dholaria, B., Labopin, M., Savani, B. N., Angelucci, E., Koc, Y., Arat, M., Pioltelli, P., Sica, S., Gülbas, Z., Tischer, J., Bernasconi, P., Pavlu, J., Socié, G., Blaise, D., Rigacci, L., Martino, M., Diez-Martin, J. L., Perić, Z., ... Mohty, M. (Accepted/In press). Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia. Leukemia. https://doi.org/10.1038/s41375-020-0850-9