PTCy-based haploidentical vs matched related or unrelated donor reduced-intensity conditioning transplant for DLBCL

Peter Dreger, Anna Sureda, Kwang Woo Ahn, Mary Eapen, Carlos Litovich, Herve Finel, Ariane Boumendil, Ajay Gopal, Alex F. Herrera, Christoph Schmid, José Luis Diez-Martin, Ephraim Fuchs, Javier Bolaños-Meade, Mahasweta Gooptu, Monzr M. Al Malki, Luca Castagna, Stefan O. Ciurea, Alida Dominietto, Didier Blaise, Fabio CiceriJohanna Tischer, Paolo Corradini, Silvia Montoto, Stephen Robinson, Zafer Gülbas, Mehdi Hamadani

Research output: Contribution to journalArticle

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Abstract

This study retrospectively compared long-term outcomes of nonmyeloablative/reduced intensity conditioning (NMC/RIC) allogeneic hematopoietic cell transplantation (allo-HCT) from a haploidentical family donor (haplo-HCT) using posttransplant cyclophosphamide (PTCy) with those of matched sibling donor (MSD) and matched unrelated donor (MUD) with or without T-cell depletion (TCD+/TCD-) in patients with relapsed diffuse large B-cell lymphoma (DLBCL). Adult patients with DLBCL who had undergone their first NMC/RIC allo-HCT between 2008 and 2015 were included. Recipients of haplo-HCT were limited to those receiving graft-versus-host disease (GVHD) prophylaxis with PTCy. GVHD prophylaxis in MSD was limited to calcineurin inhibitor (CNI)-based approaches without in vivo TCD, while MUD recipients received CNI-based prophylaxis with or without TCD. Outcome analyses for overall survival (OS) and progression-free survival (PFS), nonrelapse mortality (NRM), and disease relapse/progression were calculated. A total of 1438 patients (haplo, 132; MSD, 525; MUD TCD+, 403; and MUD TCD-, 378) were included. Patients with haplo donors were significantly older, had a better performance status and had more frequently received total body irradiation-based conditioning regimens and bone marrow grafts than MSD and MUD TCD+ or TCD-. 3-year OS, PFS, NRM and relapse/progression incidence after haplo-HCT was 46%, 38%, 22%, and 41%, respectively, and not significantly different from outcomes of matched donor transplants on multivariate analyses. Haplo-HCT was associated with a lower cumulative incidence of chronic GVHD compared with MSD, MUD TCD+/TCD-. NMC/RIC haplo-HCT with PTCy seems to be a valuable alternative for patients with DLBCL considered for allo-HCT but lacking a matched donor.

Original languageEnglish
Pages (from-to)360-369
Number of pages10
JournalBlood advances
Volume3
Issue number3
DOIs
Publication statusPublished - Feb 12 2019

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Unrelated Donors
Lymphoma, Large B-Cell, Diffuse
Cyclophosphamide
Tissue Donors
Transplants
Siblings
Cell Transplantation
Graft vs Host Disease
Disease-Free Survival
Conditioning (Psychology)
Recurrence
Mortality
Whole-Body Irradiation
Incidence
Survival Analysis
Disease Progression
Multivariate Analysis
Bone Marrow
T-Lymphocytes
Survival

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PTCy-based haploidentical vs matched related or unrelated donor reduced-intensity conditioning transplant for DLBCL. / Dreger, Peter; Sureda, Anna; Ahn, Kwang Woo; Eapen, Mary; Litovich, Carlos; Finel, Herve; Boumendil, Ariane; Gopal, Ajay; Herrera, Alex F.; Schmid, Christoph; Diez-Martin, José Luis; Fuchs, Ephraim; Bolaños-Meade, Javier; Gooptu, Mahasweta; Al Malki, Monzr M.; Castagna, Luca; Ciurea, Stefan O.; Dominietto, Alida; Blaise, Didier; Ciceri, Fabio; Tischer, Johanna; Corradini, Paolo; Montoto, Silvia; Robinson, Stephen; Gülbas, Zafer; Hamadani, Mehdi.

In: Blood advances, Vol. 3, No. 3, 12.02.2019, p. 360-369.

Research output: Contribution to journalArticle

Dreger, P, Sureda, A, Ahn, KW, Eapen, M, Litovich, C, Finel, H, Boumendil, A, Gopal, A, Herrera, AF, Schmid, C, Diez-Martin, JL, Fuchs, E, Bolaños-Meade, J, Gooptu, M, Al Malki, MM, Castagna, L, Ciurea, SO, Dominietto, A, Blaise, D, Ciceri, F, Tischer, J, Corradini, P, Montoto, S, Robinson, S, Gülbas, Z & Hamadani, M 2019, 'PTCy-based haploidentical vs matched related or unrelated donor reduced-intensity conditioning transplant for DLBCL', Blood advances, vol. 3, no. 3, pp. 360-369. https://doi.org/10.1182/bloodadvances.2018027748
Dreger, Peter ; Sureda, Anna ; Ahn, Kwang Woo ; Eapen, Mary ; Litovich, Carlos ; Finel, Herve ; Boumendil, Ariane ; Gopal, Ajay ; Herrera, Alex F. ; Schmid, Christoph ; Diez-Martin, José Luis ; Fuchs, Ephraim ; Bolaños-Meade, Javier ; Gooptu, Mahasweta ; Al Malki, Monzr M. ; Castagna, Luca ; Ciurea, Stefan O. ; Dominietto, Alida ; Blaise, Didier ; Ciceri, Fabio ; Tischer, Johanna ; Corradini, Paolo ; Montoto, Silvia ; Robinson, Stephen ; Gülbas, Zafer ; Hamadani, Mehdi. / PTCy-based haploidentical vs matched related or unrelated donor reduced-intensity conditioning transplant for DLBCL. In: Blood advances. 2019 ; Vol. 3, No. 3. pp. 360-369.
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T1 - PTCy-based haploidentical vs matched related or unrelated donor reduced-intensity conditioning transplant for DLBCL

AU - Dreger, Peter

AU - Sureda, Anna

AU - Ahn, Kwang Woo

AU - Eapen, Mary

AU - Litovich, Carlos

AU - Finel, Herve

AU - Boumendil, Ariane

AU - Gopal, Ajay

AU - Herrera, Alex F.

AU - Schmid, Christoph

AU - Diez-Martin, José Luis

AU - Fuchs, Ephraim

AU - Bolaños-Meade, Javier

AU - Gooptu, Mahasweta

AU - Al Malki, Monzr M.

AU - Castagna, Luca

AU - Ciurea, Stefan O.

AU - Dominietto, Alida

AU - Blaise, Didier

AU - Ciceri, Fabio

AU - Tischer, Johanna

AU - Corradini, Paolo

AU - Montoto, Silvia

AU - Robinson, Stephen

AU - Gülbas, Zafer

AU - Hamadani, Mehdi

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N2 - This study retrospectively compared long-term outcomes of nonmyeloablative/reduced intensity conditioning (NMC/RIC) allogeneic hematopoietic cell transplantation (allo-HCT) from a haploidentical family donor (haplo-HCT) using posttransplant cyclophosphamide (PTCy) with those of matched sibling donor (MSD) and matched unrelated donor (MUD) with or without T-cell depletion (TCD+/TCD-) in patients with relapsed diffuse large B-cell lymphoma (DLBCL). Adult patients with DLBCL who had undergone their first NMC/RIC allo-HCT between 2008 and 2015 were included. Recipients of haplo-HCT were limited to those receiving graft-versus-host disease (GVHD) prophylaxis with PTCy. GVHD prophylaxis in MSD was limited to calcineurin inhibitor (CNI)-based approaches without in vivo TCD, while MUD recipients received CNI-based prophylaxis with or without TCD. Outcome analyses for overall survival (OS) and progression-free survival (PFS), nonrelapse mortality (NRM), and disease relapse/progression were calculated. A total of 1438 patients (haplo, 132; MSD, 525; MUD TCD+, 403; and MUD TCD-, 378) were included. Patients with haplo donors were significantly older, had a better performance status and had more frequently received total body irradiation-based conditioning regimens and bone marrow grafts than MSD and MUD TCD+ or TCD-. 3-year OS, PFS, NRM and relapse/progression incidence after haplo-HCT was 46%, 38%, 22%, and 41%, respectively, and not significantly different from outcomes of matched donor transplants on multivariate analyses. Haplo-HCT was associated with a lower cumulative incidence of chronic GVHD compared with MSD, MUD TCD+/TCD-. NMC/RIC haplo-HCT with PTCy seems to be a valuable alternative for patients with DLBCL considered for allo-HCT but lacking a matched donor.

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