Peripheral blood stem cell for haploidentical transplantation with post-transplant high dose cyclophosphamide: detailed analysis of 181 consecutive patients.


Journal

Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459

Informations de publication

Date de publication:
11 2019
Historique:
received: 21 12 2018
accepted: 15 02 2019
revised: 08 02 2019
pubmed: 21 3 2019
medline: 18 9 2020
entrez: 21 3 2019
Statut: ppublish

Résumé

While bone marrow (BM) grafts were initially used for T-replete HLA-haploidentical related donors transplantation (Haplo-SCT) with post-transplantation cyclophosphamide (PT-Cy), the use of peripheral blood stem cell (PBSC) remains debated. We thus conducted a detailed analysis evaluating the incidence, risk factors, and prevalence of GVHD after PBSC Haplo-SCT with PT-Cy. One hundred and eighty-one patients with hematological diseases were included. Median time for neutrophil and platelet recovery was 21 and 30 days, respectively. The cumulative incidence of grade 3-4 acute GVHD and severe chronic GVHD were 8% and 4%, respectively, approaching what was observed after BM Haplo-SCT. NRM at 2 years was 21%, and 41% of the non-relapse deaths were caused by GVHD. The cumulative incidence of relapse at 2 years was 17% in the whole cohort, and 13% among AML patients (n = 54), suggesting a high GVL effect. As surrogate markers for good quality of life, we observed a 2-year GVHD-relapse-free survival probability of 50% and found that 6% and 2% of disease-free patients at 2 years were still living with GVHD and immunosuppressive treatments, respectively. Haplo-SCT with PT-Cy using PBSC grafts results in low incidence GVHD and promising disease control, making PBSCs a valuable alternative to BM graft in this setting.

Identifiants

pubmed: 30890770
doi: 10.1038/s41409-019-0500-x
pii: 10.1038/s41409-019-0500-x
doi:

Substances chimiques

Cyclophosphamide 8N3DW7272P

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1730-1737

Références

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Auteurs

Angela Granata (A)

Hematology Department, Institut Paoli Calmettes, Marseille, France.

Sabine Fürst (S)

Hematology Department, Institut Paoli Calmettes, Marseille, France.

Stefania Bramanti (S)

Humanitas Cancer Center, Hematology, Rozzano, Italy.

Faezeh Legrand (F)

Hematology Department, Institut Paoli Calmettes, Marseille, France.

Barbara Sarina (B)

Humanitas Cancer Center, Hematology, Rozzano, Italy.

Samia Harbi (S)

Hematology Department, Institut Paoli Calmettes, Marseille, France.

Chiara De Philippis (C)

Humanitas Cancer Center, Hematology, Rozzano, Italy.

Catherine Faucher (C)

Hematology Department, Institut Paoli Calmettes, Marseille, France.

Christian Chabannon (C)

Cell Therapy Facility, Institut Paoli Calmettes, Marseille, France.
Aix-Marseille Univ, CNRS, INSERM, Institut Paoli Calmettes, CRCM, Marseille, France.
Anesthesiology and Reanimation Department, Institut Paoli Calmettes, Marseille, France.

Claude Lemarie (C)

Anesthesiology and Reanimation Department, Institut Paoli Calmettes, Marseille, France.

Boris Calmels (B)

Anesthesiology and Reanimation Department, Institut Paoli Calmettes, Marseille, France.

Jacopo Mariotti (J)

Humanitas Cancer Center, Hematology, Rozzano, Italy.

Valerio Maisano (V)

Hematology Department, Institut Paoli Calmettes, Marseille, France.

Pierre-Jean Weiller (PJ)

Hematology Department, Institut Paoli Calmettes, Marseille, France.
Aix-Marseille Univ, CNRS, INSERM, Institut Paoli Calmettes, CRCM, Marseille, France.

Djamel Mokart (D)

Anesthesiology and Reanimation Department, Institut Paoli Calmettes, Marseille, France.

Norbert Vey (N)

Hematology Department, Institut Paoli Calmettes, Marseille, France.
Aix-Marseille Univ, CNRS, INSERM, Institut Paoli Calmettes, CRCM, Marseille, France.

Reda Bouabdallah (R)

Hematology Department, Institut Paoli Calmettes, Marseille, France.

Luca Castagna (L)

Humanitas Cancer Center, Hematology, Rozzano, Italy.

Didier Blaise (D)

Hematology Department, Institut Paoli Calmettes, Marseille, France.
Aix-Marseille Univ, CNRS, INSERM, Institut Paoli Calmettes, CRCM, Marseille, France.

Raynier Devillier (R)

Hematology Department, Institut Paoli Calmettes, Marseille, France. devillierr@ipc.unicancer.fr.
Aix-Marseille Univ, CNRS, INSERM, Institut Paoli Calmettes, CRCM, Marseille, France. devillierr@ipc.unicancer.fr.

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