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

Ali Bazarbachi, Myriam Labopin, Emanuele Angelucci, Zafer Gülbas, Hakan Ozdogu, Mutlu Arat, Luca de Rosa, Rocco Pastano, Pietro Pioltelli, Rovira Montserrat, Massimo Martino, Fabio Ciceri, Yener Koç, Gerard Socié, Didier Blaise, Concepcion Herrera, Yves Chalandon, Paolo Bernasconi, Giuseppe Marotta, Luca CastagnaAndrew McDonald, Guiseppe Visani, Paola Carluccio, Antonin Vitek, Célestine Simand, Boris Afanasyev, Wolf Rösler, J. L. Diez-Martin, Arnon Nagler, Eolia Brissot, Sebastian Giebel, Mohamad Mohty

Research output: Contribution to journalArticlepeer-review

Abstract

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.
Original languageEnglish
JournalBiol. Blood Marrow Transplant.
DOIs
Publication statusPublished - Jan 1 2020

Keywords

  • Conditioning
  • Haploidentical stem cell transplantation
  • T-ALL
  • Thiotepa
  • Total body irradiation

Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this