Haploidentical transplantation outcomes for secondary acute myeloid leukemia: Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) study

Zhuoyan Li, Myriam Labopin, Fabio Ciceri, Didier Blaise, Johanna Tischer, Gerhard Ehninger, M. T. Van Lint, Yener Koc, Stella Santarone, Edouard Forcade, Luca Castagna, Emmanuelle Polge, Audrey Mailhol, Annalisa Ruggeri, Mohamad Mohty, Bipin N. Savani, Arnon Nagler

Research output: Contribution to journalArticle

Abstract

Secondary acute myeloid leukemia (sAML) traditionally has inferior outcomes compared to de novo AML. Allogeneic hematopoietic cell transplantation (HCT) is the sole potentially curative therapy. This study analyzes the outcomes for unmanipulated haploidentical HCT (haploHCT) for sAML using the Acute Leukemia Working Party (ALWP) registry of the European Society for Blood and Marrow Transplantation (EBMT). We identified 154 patients with sAML who underwent haploHCT from 2006 to 2016. Median age at HCT was 60 years with time from diagnosis to HCT 5 months. At transplantation, 69 patients were in first CR and 85 had active disease. Fifty-seven (38.0%) patients underwent myeloablative conditioning and 97 (62.0%) reduced intensity conditioning (RIC) conditioning. Multivariate analysis showed that there was no difference in RI, nonrelapse mortality (NRM), leukemia free survival (LFS), overall survival (OS), or GVHD-free/relapse free survival (GRFS) for conditioning intensity, age, performance status, or graft source. Active disease was associated with higher RI and inferior LFS, OS, and GRFS compared with patients in CR at time of transplant. T-cell depletion with anti-thymoglobulin resulted in higher NRM and inferior LFS, OS, and GRFS compared to post-transplant cyclophosphamide (PTCy) (HR 2.25, 2.01, 2.16, and 1.73, respectively with P values <.05). Our data shows that haploHCT is a feasible alternative for sAML when matched transplantation is unavailable.

Original languageEnglish
Pages (from-to)769-777
Number of pages9
JournalAmerican Journal of Hematology
Volume93
Issue number6
DOIs
Publication statusPublished - Jun 1 2018

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Acute Myeloid Leukemia
Leukemia
Transplantation
Bone Marrow
Survival
Cell Transplantation
Transplants
Recurrence
Mortality
Cyclophosphamide
Registries
Multivariate Analysis
Outcome Assessment (Health Care)
T-Lymphocytes

ASJC Scopus subject areas

  • Hematology

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Haploidentical transplantation outcomes for secondary acute myeloid leukemia : Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) study. / Li, Zhuoyan; Labopin, Myriam; Ciceri, Fabio; Blaise, Didier; Tischer, Johanna; Ehninger, Gerhard; Van Lint, M. T.; Koc, Yener; Santarone, Stella; Forcade, Edouard; Castagna, Luca; Polge, Emmanuelle; Mailhol, Audrey; Ruggeri, Annalisa; Mohty, Mohamad; Savani, Bipin N.; Nagler, Arnon.

In: American Journal of Hematology, Vol. 93, No. 6, 01.06.2018, p. 769-777.

Research output: Contribution to journalArticle

Li, Z, Labopin, M, Ciceri, F, Blaise, D, Tischer, J, Ehninger, G, Van Lint, MT, Koc, Y, Santarone, S, Forcade, E, Castagna, L, Polge, E, Mailhol, A, Ruggeri, A, Mohty, M, Savani, BN & Nagler, A 2018, 'Haploidentical transplantation outcomes for secondary acute myeloid leukemia: Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) study', American Journal of Hematology, vol. 93, no. 6, pp. 769-777. https://doi.org/10.1002/ajh.25087
Li, Zhuoyan ; Labopin, Myriam ; Ciceri, Fabio ; Blaise, Didier ; Tischer, Johanna ; Ehninger, Gerhard ; Van Lint, M. T. ; Koc, Yener ; Santarone, Stella ; Forcade, Edouard ; Castagna, Luca ; Polge, Emmanuelle ; Mailhol, Audrey ; Ruggeri, Annalisa ; Mohty, Mohamad ; Savani, Bipin N. ; Nagler, Arnon. / Haploidentical transplantation outcomes for secondary acute myeloid leukemia : Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) study. In: American Journal of Hematology. 2018 ; Vol. 93, No. 6. pp. 769-777.
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abstract = "Secondary acute myeloid leukemia (sAML) traditionally has inferior outcomes compared to de novo AML. Allogeneic hematopoietic cell transplantation (HCT) is the sole potentially curative therapy. This study analyzes the outcomes for unmanipulated haploidentical HCT (haploHCT) for sAML using the Acute Leukemia Working Party (ALWP) registry of the European Society for Blood and Marrow Transplantation (EBMT). We identified 154 patients with sAML who underwent haploHCT from 2006 to 2016. Median age at HCT was 60 years with time from diagnosis to HCT 5 months. At transplantation, 69 patients were in first CR and 85 had active disease. Fifty-seven (38.0{\%}) patients underwent myeloablative conditioning and 97 (62.0{\%}) reduced intensity conditioning (RIC) conditioning. Multivariate analysis showed that there was no difference in RI, nonrelapse mortality (NRM), leukemia free survival (LFS), overall survival (OS), or GVHD-free/relapse free survival (GRFS) for conditioning intensity, age, performance status, or graft source. Active disease was associated with higher RI and inferior LFS, OS, and GRFS compared with patients in CR at time of transplant. T-cell depletion with anti-thymoglobulin resulted in higher NRM and inferior LFS, OS, and GRFS compared to post-transplant cyclophosphamide (PTCy) (HR 2.25, 2.01, 2.16, and 1.73, respectively with P values <.05). Our data shows that haploHCT is a feasible alternative for sAML when matched transplantation is unavailable.",
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AU - Labopin, Myriam

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AU - Blaise, Didier

AU - Tischer, Johanna

AU - Ehninger, Gerhard

AU - Van Lint, M. T.

AU - Koc, Yener

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AU - Forcade, Edouard

AU - Castagna, Luca

AU - Polge, Emmanuelle

AU - Mailhol, Audrey

AU - Ruggeri, Annalisa

AU - Mohty, Mohamad

AU - Savani, Bipin N.

AU - Nagler, Arnon

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N2 - Secondary acute myeloid leukemia (sAML) traditionally has inferior outcomes compared to de novo AML. Allogeneic hematopoietic cell transplantation (HCT) is the sole potentially curative therapy. This study analyzes the outcomes for unmanipulated haploidentical HCT (haploHCT) for sAML using the Acute Leukemia Working Party (ALWP) registry of the European Society for Blood and Marrow Transplantation (EBMT). We identified 154 patients with sAML who underwent haploHCT from 2006 to 2016. Median age at HCT was 60 years with time from diagnosis to HCT 5 months. At transplantation, 69 patients were in first CR and 85 had active disease. Fifty-seven (38.0%) patients underwent myeloablative conditioning and 97 (62.0%) reduced intensity conditioning (RIC) conditioning. Multivariate analysis showed that there was no difference in RI, nonrelapse mortality (NRM), leukemia free survival (LFS), overall survival (OS), or GVHD-free/relapse free survival (GRFS) for conditioning intensity, age, performance status, or graft source. Active disease was associated with higher RI and inferior LFS, OS, and GRFS compared with patients in CR at time of transplant. T-cell depletion with anti-thymoglobulin resulted in higher NRM and inferior LFS, OS, and GRFS compared to post-transplant cyclophosphamide (PTCy) (HR 2.25, 2.01, 2.16, and 1.73, respectively with P values <.05). Our data shows that haploHCT is a feasible alternative for sAML when matched transplantation is unavailable.

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