Post-transplantation cyclophosphamide-based haploidentical versus Atg-based unrelated donor allogeneic stem cell transplantation for patients younger than 60 years with hematological malignancies: a single-center experience of 209 patients

Thomas Pagliardini, Samia Harbi, Sabine Fürst, Luca Castagna, Faezeh Legrand, Catherine Faucher, Angela Granata, Pierre-Jean Weiller, Boris Calmels, Claude Lemarie, Christian Chabannon, Reda Bouabdallah, Djamel Mokart, Norbert Vey, Didier Blaise, Raynier Devillier

Research output: Contribution to journalArticle

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is limited by availability of HLA-matched sibling donors (MSDs). The alternative use of unrelated donors (UDs) is currently challenged by haploidentical-related donors (HRDs). We retrospectively analyzed 209 consecutive patients younger than 60 years undergoing allo-HSCT from UDs (n = 128) or HRDs (n = 81). Cumulative incidences of grade 3-4 acute (17 vs. 2%, p = 0.003) and 2-year moderate and severe chronic (20 vs. 2%, p < 0.001) GVHD were significantly higher with UD. Progression-free survival (PFS) was significantly better with HRD (51 vs. 69%, p = 0.019), without significant difference in the cumulative incidence of relapse (CIR), non-relapse mortality (NRM), and overall survival (OS). Multivariate analyses confirmed the lower risk of acute and chronic GVHD (grade 2-4, HR = 0.43, p = 0.005; grade 3-4, HR = 0.20, p = 0.017; all grades, HR = 0.43, p = 0.012; moderate or severe, HR = 0.12, p = 0.004), better PFS (HR = 0.61, p = 0.046), and GRFS (HR = 0.47, p = 0.001) with HRD. This was confirmed in match-paired analysis. In the absence of MSDs, HRD could be considered as a suitable alternative for patients younger than 60 years.

Original languageEnglish
JournalBone Marrow Transplantation
DOIs
Publication statusE-pub ahead of print - Nov 6 2018

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Unrelated Donors
Stem Cell Transplantation
Hematologic Neoplasms
Cyclophosphamide
Transplantation
Tissue Donors
Hematopoietic Stem Cell Transplantation
Disease-Free Survival
Siblings
Incidence
Multivariate Analysis
Recurrence
Survival
Mortality

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Post-transplantation cyclophosphamide-based haploidentical versus Atg-based unrelated donor allogeneic stem cell transplantation for patients younger than 60 years with hematological malignancies : a single-center experience of 209 patients. / Pagliardini, Thomas; Harbi, Samia; Fürst, Sabine; Castagna, Luca; Legrand, Faezeh; Faucher, Catherine; Granata, Angela; Weiller, Pierre-Jean; Calmels, Boris; Lemarie, Claude; Chabannon, Christian; Bouabdallah, Reda; Mokart, Djamel; Vey, Norbert; Blaise, Didier; Devillier, Raynier.

In: Bone Marrow Transplantation, 06.11.2018.

Research output: Contribution to journalArticle

Pagliardini, Thomas ; Harbi, Samia ; Fürst, Sabine ; Castagna, Luca ; Legrand, Faezeh ; Faucher, Catherine ; Granata, Angela ; Weiller, Pierre-Jean ; Calmels, Boris ; Lemarie, Claude ; Chabannon, Christian ; Bouabdallah, Reda ; Mokart, Djamel ; Vey, Norbert ; Blaise, Didier ; Devillier, Raynier. / Post-transplantation cyclophosphamide-based haploidentical versus Atg-based unrelated donor allogeneic stem cell transplantation for patients younger than 60 years with hematological malignancies : a single-center experience of 209 patients. In: Bone Marrow Transplantation. 2018.
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abstract = "Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is limited by availability of HLA-matched sibling donors (MSDs). The alternative use of unrelated donors (UDs) is currently challenged by haploidentical-related donors (HRDs). We retrospectively analyzed 209 consecutive patients younger than 60 years undergoing allo-HSCT from UDs (n = 128) or HRDs (n = 81). Cumulative incidences of grade 3-4 acute (17 vs. 2{\%}, p = 0.003) and 2-year moderate and severe chronic (20 vs. 2{\%}, p < 0.001) GVHD were significantly higher with UD. Progression-free survival (PFS) was significantly better with HRD (51 vs. 69{\%}, p = 0.019), without significant difference in the cumulative incidence of relapse (CIR), non-relapse mortality (NRM), and overall survival (OS). Multivariate analyses confirmed the lower risk of acute and chronic GVHD (grade 2-4, HR = 0.43, p = 0.005; grade 3-4, HR = 0.20, p = 0.017; all grades, HR = 0.43, p = 0.012; moderate or severe, HR = 0.12, p = 0.004), better PFS (HR = 0.61, p = 0.046), and GRFS (HR = 0.47, p = 0.001) with HRD. This was confirmed in match-paired analysis. In the absence of MSDs, HRD could be considered as a suitable alternative for patients younger than 60 years.",
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T1 - Post-transplantation cyclophosphamide-based haploidentical versus Atg-based unrelated donor allogeneic stem cell transplantation for patients younger than 60 years with hematological malignancies

T2 - a single-center experience of 209 patients

AU - Pagliardini, Thomas

AU - Harbi, Samia

AU - Fürst, Sabine

AU - Castagna, Luca

AU - Legrand, Faezeh

AU - Faucher, Catherine

AU - Granata, Angela

AU - Weiller, Pierre-Jean

AU - Calmels, Boris

AU - Lemarie, Claude

AU - Chabannon, Christian

AU - Bouabdallah, Reda

AU - Mokart, Djamel

AU - Vey, Norbert

AU - Blaise, Didier

AU - Devillier, Raynier

PY - 2018/11/6

Y1 - 2018/11/6

N2 - Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is limited by availability of HLA-matched sibling donors (MSDs). The alternative use of unrelated donors (UDs) is currently challenged by haploidentical-related donors (HRDs). We retrospectively analyzed 209 consecutive patients younger than 60 years undergoing allo-HSCT from UDs (n = 128) or HRDs (n = 81). Cumulative incidences of grade 3-4 acute (17 vs. 2%, p = 0.003) and 2-year moderate and severe chronic (20 vs. 2%, p < 0.001) GVHD were significantly higher with UD. Progression-free survival (PFS) was significantly better with HRD (51 vs. 69%, p = 0.019), without significant difference in the cumulative incidence of relapse (CIR), non-relapse mortality (NRM), and overall survival (OS). Multivariate analyses confirmed the lower risk of acute and chronic GVHD (grade 2-4, HR = 0.43, p = 0.005; grade 3-4, HR = 0.20, p = 0.017; all grades, HR = 0.43, p = 0.012; moderate or severe, HR = 0.12, p = 0.004), better PFS (HR = 0.61, p = 0.046), and GRFS (HR = 0.47, p = 0.001) with HRD. This was confirmed in match-paired analysis. In the absence of MSDs, HRD could be considered as a suitable alternative for patients younger than 60 years.

AB - Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is limited by availability of HLA-matched sibling donors (MSDs). The alternative use of unrelated donors (UDs) is currently challenged by haploidentical-related donors (HRDs). We retrospectively analyzed 209 consecutive patients younger than 60 years undergoing allo-HSCT from UDs (n = 128) or HRDs (n = 81). Cumulative incidences of grade 3-4 acute (17 vs. 2%, p = 0.003) and 2-year moderate and severe chronic (20 vs. 2%, p < 0.001) GVHD were significantly higher with UD. Progression-free survival (PFS) was significantly better with HRD (51 vs. 69%, p = 0.019), without significant difference in the cumulative incidence of relapse (CIR), non-relapse mortality (NRM), and overall survival (OS). Multivariate analyses confirmed the lower risk of acute and chronic GVHD (grade 2-4, HR = 0.43, p = 0.005; grade 3-4, HR = 0.20, p = 0.017; all grades, HR = 0.43, p = 0.012; moderate or severe, HR = 0.12, p = 0.004), better PFS (HR = 0.61, p = 0.046), and GRFS (HR = 0.47, p = 0.001) with HRD. This was confirmed in match-paired analysis. In the absence of MSDs, HRD could be considered as a suitable alternative for patients younger than 60 years.

U2 - 10.1038/s41409-018-0387-y

DO - 10.1038/s41409-018-0387-y

M3 - Article

C2 - 30401970

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

ER -