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

Federica Giannotti, Myriam Labopin, Roni Shouval, Jaime Sanz, William Arcese, Emanuele Angelucci, Jorge Sierra, Josep-Maria Ribera Santasusana, Stella Santarone, Bruno Benedetto, Alessandro Rambaldi, Riccardo Saccardi, Didier Blaise, Michele Angelo Carella, Vanderson Rocha, Frederic Baron, Mohamad Mohty, Annalisa Ruggeri, Arnon Nagler

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)110
Number of pages10
JournalJournal of Hematology and Oncology
Volume11
Issue number1
DOIs
Publication statusPublished - Aug 30 2018

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Thiotepa
Busulfan
Fetal Blood
Leukemia
Transplantation
Survival
Graft vs Host Disease
Tissue Donors
Transplants
Recurrence
Mortality
Stem Cell Transplantation
fludarabine
Acute Myeloid Leukemia
Disease-Free Survival
Registries
Multivariate Analysis
Retrospective Studies
Incidence

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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 journalArticle

Giannotti, F, Labopin, M, Shouval, R, Sanz, J, Arcese, W, Angelucci, E, Sierra, J, Santasusana, J-MR, Santarone, S, Benedetto, B, Rambaldi, A, Saccardi, R, Blaise, D, Carella, MA, Rocha, V, Baron, F, Mohty, M, Ruggeri, A & Nagler, A 2018, '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', Journal of Hematology and Oncology, vol. 11, no. 1, pp. 110. https://doi.org/10.1186/s13045-018-0655-8
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. / 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. In: Journal of Hematology and Oncology. 2018 ; Vol. 11, No. 1. pp. 110.
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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.",
author = "Federica Giannotti and Myriam Labopin and Roni Shouval and Jaime Sanz and William Arcese and Emanuele Angelucci and Jorge Sierra and Santasusana, {Josep-Maria Ribera} and Stella Santarone and Bruno Benedetto and Alessandro Rambaldi and Riccardo Saccardi and Didier Blaise and Carella, {Michele Angelo} and Vanderson Rocha and Frederic Baron and Mohamad Mohty and Annalisa Ruggeri and Arnon Nagler",
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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

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