Abstract
BACKGROUND: Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established.
METHODS: This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics.
RESULTS: SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1.03, p = 0.92 or HR = 1.86, p = 0.21) and relapse incidence (HR = 0.8, p = 0.65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2.63, p = 0.001); moreover, SUCBT did worse in terms of overall survival (HR = 2.18, p = 0.002), leukemia-free survival (HR = 1.94, p = 0.007), and GvHD relapse-free survival (HR = 2.38, p = 0.0002).
CONCLUSIONS: Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM.
| Original language | English |
|---|---|
| Pages (from-to) | 110 |
| Number of pages | 10 |
| Journal | Journal of Hematology and Oncology |
| Volume | 11 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Aug 30 2018 |
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Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation : an EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine. / Giannotti, Federica; Labopin, Myriam; Shouval, Roni; Sanz, Jaime; Arcese, William; Angelucci, Emanuele; Sierra, Jorge; Santasusana, Josep-Maria Ribera; Santarone, Stella; Benedetto, Bruno; Rambaldi, Alessandro; Saccardi, Riccardo; Blaise, Didier; Carella, Michele Angelo; Rocha, Vanderson; Baron, Frederic; Mohty, Mohamad; Ruggeri, Annalisa; Nagler, Arnon.
In: Journal of Hematology and Oncology, Vol. 11, No. 1, 30.08.2018, p. 110.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation
T2 - an EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine
AU - Giannotti, Federica
AU - Labopin, Myriam
AU - Shouval, Roni
AU - Sanz, Jaime
AU - Arcese, William
AU - Angelucci, Emanuele
AU - Sierra, Jorge
AU - Santasusana, Josep-Maria Ribera
AU - Santarone, Stella
AU - Benedetto, Bruno
AU - Rambaldi, Alessandro
AU - Saccardi, Riccardo
AU - Blaise, Didier
AU - Carella, Michele Angelo
AU - Rocha, Vanderson
AU - Baron, Frederic
AU - Mohty, Mohamad
AU - Ruggeri, Annalisa
AU - Nagler, Arnon
PY - 2018/8/30
Y1 - 2018/8/30
N2 - BACKGROUND: Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established.METHODS: This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics.RESULTS: SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1.03, p = 0.92 or HR = 1.86, p = 0.21) and relapse incidence (HR = 0.8, p = 0.65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2.63, p = 0.001); moreover, SUCBT did worse in terms of overall survival (HR = 2.18, p = 0.002), leukemia-free survival (HR = 1.94, p = 0.007), and GvHD relapse-free survival (HR = 2.38, p = 0.0002).CONCLUSIONS: Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM.
AB - BACKGROUND: Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established.METHODS: This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics.RESULTS: SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1.03, p = 0.92 or HR = 1.86, p = 0.21) and relapse incidence (HR = 0.8, p = 0.65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2.63, p = 0.001); moreover, SUCBT did worse in terms of overall survival (HR = 2.18, p = 0.002), leukemia-free survival (HR = 1.94, p = 0.007), and GvHD relapse-free survival (HR = 2.38, p = 0.0002).CONCLUSIONS: Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM.
U2 - 10.1186/s13045-018-0655-8
DO - 10.1186/s13045-018-0655-8
M3 - Article
C2 - 30165887
VL - 11
SP - 110
JO - Journal of Hematology and Oncology
JF - Journal of Hematology and Oncology
SN - 1756-8722
IS - 1
ER -