Bone marrow versus mobilized peripheral blood stem cell graft in T-cell-replete haploidentical transplantation in acute lymphoblastic leukemia.
Bone Marrow Transplantation
/ adverse effects
Cause of Death
Combined Modality Therapy
Female
Graft vs Host Disease
/ diagnosis
Hematopoietic Stem Cell Mobilization
Humans
Lymphocyte Depletion
Male
Peripheral Blood Stem Cell Transplantation
/ adverse effects
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/ diagnosis
Proportional Hazards Models
T-Lymphocytes
Transplantation Conditioning
/ methods
Transplantation, Haploidentical
Treatment Outcome
Journal
Leukemia
ISSN: 1476-5551
Titre abrégé: Leukemia
Pays: England
ID NLM: 8704895
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
26
12
2019
accepted:
27
04
2020
revised:
23
04
2020
pubmed:
13
5
2020
medline:
1
12
2020
entrez:
13
5
2020
Statut:
ppublish
Résumé
The ideal stem cell graft source remains unknown in haploidentical haematopietic cell transplantation (haplo-HCT) with posttransplantation cyclophosphamide (PTCy). This study compared outcomes of bone marrow (BM) versus peripheral blood (PB) stem cell graft for haplo-HCT in acute lymphoblastic leukemia (ALL). A total of 314 patients with ALL (BM-157; PB-157) were included in this study. The cumulative incidence of engraftment at day 30 was higher in the PB group compared with BM (93% vs. 88%, p < 0.01). The incidences of acute graft-versus-host disease (GVHD) and chronic GVHD were not significantly different between the study cohorts. In the multivariate analysis, there were tendencies toward a higher incidence of grade II-IV acute GVHD (hazard ratio (HR) = 1.52, p = 0.07), chronic GVHD (HR = 1.58, p = 0.05), and nonrelapse mortality (NRM) (HR = 1.66, p = 0.06) in patients receiving PB versus BM graft, respectively. The use of PB grafts was associated with lower leukemia-free survival (LFS) (HR = 1.43, p = 0.05), overall survival (OS) (HR = 1.59, p = 0.02), and GVHD-free, relapse-free survival (GRFS) (HR = 1.42, p = 0.03) compared with BM grafts. There was no difference in relapse incidence (HR = 1.23, p = 0.41) between the study groups. In conclusion, use of BM graft results in better survival after haplo-HCT with PTCy in patients with ALL, compared with PB stem cell graft.
Identifiants
pubmed: 32393841
doi: 10.1038/s41375-020-0850-9
pii: 10.1038/s41375-020-0850-9
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2766-2775Références
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