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Reduced-intensity transplantation for lymphomas using haploidentical related donors vs HLA-matched unrelated donors

Kanate, Abraham S. (author)
W Virginia Univ, Osborn Hematopoiet Malignancy & Transplantat Prog, Morgantown, WV 26506 USA.
Mussetti, Alberto (author)
Ist Nazl Tumori, Fdn Ist Ricovero & Cura Carattere Sci, SC Ematol & Trapianto Midollo Osseo, Via Venezian 1, I-20133 Milan, Italy.
Kharfan-Dabaja, Mohamed A. (author)
H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA.
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Ahn, Kwang W. (author)
Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA.
DiGilio, Alyssa (author)
Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI 53226 USA.
Beitinjaneh, Amer (author)
Emily Couric Clin Canc Ctr, Div Hematol Oncol, Dept Med, Charlottesville, VA USA.
Chhabra, Saurabh (author)
Med Univ S Carolina, Div Hematol Oncol, Charleston, SC 29425 USA.
Fenske, Timothy S. (author)
Med Coll Wisconsin, Froedtert Mem Lutheran Hosp, Dept Hematol Oncol, Milwaukee, WI 53226 USA.
Freytes, Cesar (author)
South Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA.;Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA.
Gale, Robert Peter (author)
Univ London Imperial Coll Sci Technol & Med, Dept Med, Hematol Res Ctr, Div Expt Med, London, England.
Ganguly, Siddhartha (author)
Univ Kansas, Med Ctr, Blood & Marrow Transplantat, Div Hematol & Oncol, Kansas City, KS 66103 USA.
Hertzberg, Mark (author)
Prince Wales Hosp, Dept Haematol, Randwick, NSW 2031, Australia.
Klyuchnikov, Evgeny (author)
Univ Canc Ctr, Dept Stem Cell Transplantat, Hamburg, Germany.
Lazarus, Hillard M. (author)
Univ Hosp, Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA.
Olsson, Richard (author)
Karolinska Institutet,Uppsala universitet,Hematologi,Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden.
Perales, Miguel-Angel (author)
Mem Sloan Kettering Canc Ctr, Adult Marrow Transplantat Serv, Dept Med, 1275 York Ave, New York, NY 10021 USA.
Rezvani, Andrew (author)
Stanford Univ, Med Ctr, Blood & Marrow Transplantat, Stanford, CA 94305 USA.
Riches, Marcie (author)
Univ N Carolina, Div Hematol Oncol, Chapel Hill, NC USA.
Saad, Ayman (author)
Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA.
Slavin, Shimon (author)
Int Ctr Cell Therapy & Canc Immunotherapy, Tel Aviv, Israel.
Smith, Sonali M. (author)
Univ Chicago, Hematol Oncol Sect, Chicago, IL 60637 USA.
Sureda, Anna (author)
Hosp Duran I Reynals, Inst Catala Oncol, Serv Hematol, Barcelona, Spain.
Yared, Jean (author)
Univ Maryland, Greenebaum Canc Ctr, Blood & Marrow Transplantat Program, Div Hematol Oncol,Dept Med, Baltimore, MD 21201 USA.
Ciurea, Stefan (author)
Univ Texas Houston, MD Anderson Canc Ctr, Dept Hematol, 1515 Holcombe Blvd, Houston, TX 77030 USA.
Armand, Philippe (author)
Dana Farber Canc Inst, Dept Med Oncol Hematol Malignancies, Boston, MA 02115 USA.
Salit, Rachel (author)
Fred Hutchinson Canc Res Ctr, Dept Hematol Oncol, 1124 Columbia St, Seattle, WA 98104 USA.
Bolanos-Meade, Javier (author)
Johns Hopkins Univ, Sidney Kimmel Canc Ctr, Div Hematol Malignancies, Baltimore, MD USA.
Hamadani, Mehdi (author)
Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI 53226 USA.
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W Virginia Univ, Osborn Hematopoiet Malignancy & Transplantat Prog, Morgantown, WV 26506 USA Ist Nazl Tumori, Fdn Ist Ricovero & Cura Carattere Sci, SC Ematol & Trapianto Midollo Osseo, Via Venezian 1, I-20133 Milan, Italy. (creator_code:org_t)
American Society of Hematology, 2016
2016
English.
In: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 127:7, s. 938-947
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • We evaluated 917 adult lymphoma patients who received haploidentical (n = 185) or HLA-matched unrelated donor (URD) transplantation either with (n = 241) or without antithymocyte globulin (ATG; n = 491) following reduced-intensity conditioning regimens. Haploidentical recipients received posttransplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis, whereas URD recipients received calcineurin inhibitor-based prophylaxis. Median follow-up of survivors was 3 years. The 100-day cumulative incidence of grade III-IV acute GVHD on univariate analysis was 8%, 12%, and 17% in the haploidentical, URD without ATG, and URD with ATG groups, respectively (P = .44). Corresponding 1-year rates of chronic GVHD on univariate analysis were 13%, 51%, and 33%, respectively (P < .001). On multivariate analysis, grade III-IV acute GVHD was higher in URD without ATG (P = .001), as well as URD with ATG (P = .01), relative to haploidentical transplants. Similarly, relative to haploidentical transplants, risk of chronic GVHD was higher in URD without ATG and URD with ATG (P < .0001). Cumulative incidence of relapse/progression at 3 years was 36%, 28%, and 36% in the haploidentical, URD without ATG, and URD with ATG groups, respectively (P = .07). Corresponding 3-year overall survival (OS) was 60%, 62%, and 50% in the 3 groups, respectively, with multivariate analysis showing no survival difference between URD without ATG (P = .21) or URD with ATG (P = .16), relative to haploidentical transplants. Multivariate analysis showed no difference between the 3 groups in terms of nonrelapse mortality (NRM), relapse/progression, and progression-free survival (PFS). These data suggest that reduced-intensity conditioning haploidentical transplantation with posttransplant cyclophosphamide does not compromise early survival outcomes compared with matched URD transplantation, and is associated with significantly reduced risk of chronic GVHD.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Hematologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Hematology (hsv//eng)

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