TY - JOUR
T1 - Comparable survival using a CMV-matched or a mismatched donor for CMV+ patients undergoing T-replete haplo-HSCT with PT-Cy for acute leukemia:
T2 - a study of behalf of the infectious diseases and acute leukemia working parties of the EBMT
AU - Cesaro, Simone
AU - Crocchiolo, Roberto
AU - Tridello, Gloria
AU - Knelange, Nina
AU - Van Lint, Maria Teresa
AU - Koc, Yener
AU - Ciceri, Fabio
AU - Gülbas, Zafer
AU - Tischer, Johanna
AU - Afanasyev, Boris
AU - Bruno, Benedetto
AU - Castagna, Luca
AU - Blaise, Didier
AU - Mohty, Mohamad
AU - Irrera, Giuseppe
AU - Diez-Martin, J. L.
AU - Pierelli, Luca
AU - Pioltelli, Pietro
AU - Arat, Mutlu
AU - Delia, Mario
AU - Fagioli, Franca
AU - Ehninger, Gerhard
AU - Aljurf, Mahmoud
AU - Carella, Angelo Michele
AU - Ozdogu, Hakan
AU - Mikulska, Malgorzata
AU - Ljungman, Per
AU - Nagler, Arnon
AU - Styczynski, Jan
PY - 2018/4/1
Y1 - 2018/4/1
N2 - The role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4-24.8) and 18.8% (95% CI: 13.8-25.5) in the CMV D+/R+ and D-/R+ pairs, respectively (p = 0.40). Similarly, 1-year OS was 55.1% (95% CI: 50.1-58.0) and 55.7% (95% CI: 48.0-62.8) in the same groups (p = 0.50). The other main outcomes were comparable. No difference in NRM nor OS was observed after stratification for the intensity of conditioning and multivariate anaysis confirmed the lack of significant association with NRM or OS. In conclusion, the choice of a CMV-seronegative donor did not impair early survival of CMV-seropositive patients with acute leukemia after a first, non T-cell depleted haploidentical HSCT and PT-Cy among this series of 983 consecutive patients. Future research may focus on the assessment of the hierarchy of all the donor variables.
AB - The role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4-24.8) and 18.8% (95% CI: 13.8-25.5) in the CMV D+/R+ and D-/R+ pairs, respectively (p = 0.40). Similarly, 1-year OS was 55.1% (95% CI: 50.1-58.0) and 55.7% (95% CI: 48.0-62.8) in the same groups (p = 0.50). The other main outcomes were comparable. No difference in NRM nor OS was observed after stratification for the intensity of conditioning and multivariate anaysis confirmed the lack of significant association with NRM or OS. In conclusion, the choice of a CMV-seronegative donor did not impair early survival of CMV-seropositive patients with acute leukemia after a first, non T-cell depleted haploidentical HSCT and PT-Cy among this series of 983 consecutive patients. Future research may focus on the assessment of the hierarchy of all the donor variables.
U2 - 10.1038/s41409-017-0016-1
DO - 10.1038/s41409-017-0016-1
M3 - Article
VL - 53
SP - 422
EP - 430
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
IS - 4
ER -