TY - JOUR
T1 - Haploidentical Transplantation with Post-Transplantation Cyclophosphamide for T Cell Acute Lymphoblastic Leukemia: A Report from the European Society for Blood and Marrow Transplantation Acute Leukemia Working Party
AU - Bazarbachi, Ali
AU - Labopin, Myriam
AU - Angelucci, Emanuele
AU - Gülbas, Zafer
AU - Ozdogu, Hakan
AU - Arat, Mutlu
AU - de Rosa, Luca
AU - Pastano, Rocco
AU - Pioltelli, Pietro
AU - Montserrat, Rovira
AU - Martino, Massimo
AU - Ciceri, Fabio
AU - Koç, Yener
AU - Socié, Gerard
AU - Blaise, Didier
AU - Herrera, Concepcion
AU - Chalandon, Yves
AU - Bernasconi, Paolo
AU - Marotta, Giuseppe
AU - Castagna, Luca
AU - McDonald, Andrew
AU - Visani, Guiseppe
AU - Carluccio, Paola
AU - Vitek, Antonin
AU - Simand, Célestine
AU - Afanasyev, Boris
AU - Rösler, Wolf
AU - Diez-Martin, J. L.
AU - Nagler, Arnon
AU - Brissot, Eolia
AU - Giebel, Sebastian
AU - Mohty, Mohamad
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Allogeneic hematopoietic cell transplantation (HCT) is recommended in high-risk patients with T cell acute lymphoblastic leukemia (T-ALL). For patients without an HLA-identical donor, haploidentical (haplo-) HCT is becoming the leading source of stem cell donation. However, data are scarce on predictive factors for outcome in that setting. We identified 122 adults (20% female; median age, 31 years; range, 18 to 68 years) with T-ALL who underwent haplo-HCT with post-transplantation cyclophosphamide (ptCy) between 2010 and 2017. The median duration of follow-up of living patients was 23 months. The 2-year incidences of relapse and nonrelapse mortality were 45% and 21%, respectively. The 2-year leukemia-free survival (LFS), overall survival (OS), and graft-versus-host disease, relapse-free survival (GRFS) were 34%, 42%, and 27%, respectively. The 2-year LFS and OS were highly influenced by disease status at transplantation, being 49% and 55%, respectively, for patients in first complete remission (CR1); 34% and 50%, respectively, for those in second CR (CR2); and 8% and 12%, respectively, for patients with active disease. On multivariate analysis, only disease status was found to affect LFS and OS. Transplantation in CR2 negatively affected LFS, whereas active disease at the time of haplo-HCT negatively affected LFS and OS. In conclusion, haplo-HCT with ptCy produced encouraging results in this challenging disease, particularly when performed in patients in CR. Despite the limitation of the small sample size, our results were not affected by the type of conditioning, calling into question the need for total body irradiation-based myeloablative conditioning in that setting.
AB - Allogeneic hematopoietic cell transplantation (HCT) is recommended in high-risk patients with T cell acute lymphoblastic leukemia (T-ALL). For patients without an HLA-identical donor, haploidentical (haplo-) HCT is becoming the leading source of stem cell donation. However, data are scarce on predictive factors for outcome in that setting. We identified 122 adults (20% female; median age, 31 years; range, 18 to 68 years) with T-ALL who underwent haplo-HCT with post-transplantation cyclophosphamide (ptCy) between 2010 and 2017. The median duration of follow-up of living patients was 23 months. The 2-year incidences of relapse and nonrelapse mortality were 45% and 21%, respectively. The 2-year leukemia-free survival (LFS), overall survival (OS), and graft-versus-host disease, relapse-free survival (GRFS) were 34%, 42%, and 27%, respectively. The 2-year LFS and OS were highly influenced by disease status at transplantation, being 49% and 55%, respectively, for patients in first complete remission (CR1); 34% and 50%, respectively, for those in second CR (CR2); and 8% and 12%, respectively, for patients with active disease. On multivariate analysis, only disease status was found to affect LFS and OS. Transplantation in CR2 negatively affected LFS, whereas active disease at the time of haplo-HCT negatively affected LFS and OS. In conclusion, haplo-HCT with ptCy produced encouraging results in this challenging disease, particularly when performed in patients in CR. Despite the limitation of the small sample size, our results were not affected by the type of conditioning, calling into question the need for total body irradiation-based myeloablative conditioning in that setting.
KW - Conditioning
KW - Haploidentical stem cell transplantation
KW - T-ALL
KW - Thiotepa
KW - Total body irradiation
U2 - 10.1016/j.bbmt.2020.01.003
DO - 10.1016/j.bbmt.2020.01.003
M3 - Article
JO - Biol. Blood Marrow Transplant.
JF - Biol. Blood Marrow Transplant.
SN - 1083-8791
ER -