Comparison of long-term outcome for AML patients alive free of disease 2 years after allogeneic hematopoietic cell transplantation with umbilical cord blood versus unrelated donor: a study from the ALWP of the EBMT.
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
11
04
2021
accepted:
21
06
2021
revised:
29
05
2021
pubmed:
12
7
2021
medline:
11
3
2022
entrez:
11
7
2021
Statut:
ppublish
Résumé
Since cord blood transplantation (CBT) has been associated with high graft-versus-leukemia effects and a low incidence of chronic graft-versus-host disease (GVHD), we hypothesized that long-term outcomes might be better in CBT patients than in those given grafts from unrelated donors (UD). Therefore, we performed a landmark study comparing long-term outcomes in acute myeloid leukemia (AML) patients alive and disease-free 2 years after transplantation who received grafts from either CBT or UD. A total of 364 CBT recipients, 2648 UD 10/10 patients and 681 patients given grafts from UD 9/10 were included. Median follow-up was 6.0 years. Five-year leukemia-free survival (LFS) from transplantation was 86% in CBT patients, 84% in UD 10/10 patients (P = 0.36) and 84% in UD 9/10 patients (P = 0.86). On multivariate analysis, donor type had no impact on LFS. Similarly, no impact of donor type was observed on relapse incidence or non-relapse mortality. Factors associated with poorer LFS on multivariate analysis included higher age at transplantation (P < 0.001), male gender (P < 0.001), second complete remission (CR2) versus CR1 (P = 0.05), secondary AML (P = 0.01), antecedent of chronic GVHD (P < 0.001) and poor-risk cytogenetics (P = 0.01). In conclusion, our study shows that long-term outcome for AML patients in CR two years after transplantation is not impacted by donor type.
Identifiants
pubmed: 34247199
doi: 10.1038/s41409-021-01387-7
pii: 10.1038/s41409-021-01387-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2742-2748Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
Références
Dohner H, Estey E, Grimwade D, Amadori S, Appelbaum FR, Buchner T, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017;129:424–47.
doi: 10.1182/blood-2016-08-733196
Baron F, Efficace F, Cannella L, Muus P, Trisolini S, Halkes CJM, et al. Impact of the type of anthracycline and of stem cell transplantation in younger patients with acute myeloid leukemia: Long-term follow up of a phase III study. Am J Hematol. 2020;95:749–58.
doi: 10.1002/ajh.25795
Baron F, Stevens-Kroef M, Kicinski M, Meloni G, Muus P, Marie J-P, et al. Impact of induction regimen and allogeneic hematopoietic cell transplantation on outcome in younger adults with acute myeloid leukemia with a monosomal karyotype. Haematologica. 2019;104:1168–75.
doi: 10.3324/haematol.2018.204826
Baron F, Efficace F, Cannella L, Willemze R, Vignetti M, Muus P, et al. Long-term follow-up of a trial comparing post-remission treatment with autologous or allogeneic bone marrow transplantation or intensive chemotherapy in younger acute myeloid leukemia patients. Haematologica. 2020;105:e13–e16.
doi: 10.3324/haematol.2019.221333
Baron F, Labopin M, Blaise D, Itälä-Remes M, Socié G, Forcade E, et al. Better leukemia-free survival with allogeneic than with autologous HCT in AML patients with isolated trisomy 8: a study from the ALWP of the EBMT. Bone Marrow Transpl. 2020. https://doi.org/10.1038/s41409-020-01051-6 .
Eapen M, Rocha V, Sanz G, Scaradavou A, Zhang M-J, Arcese W, et al. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis. Lancet Oncol. 2010;11:653–60.
doi: 10.1016/S1470-2045(10)70127-3
Konuma T, Tsukada N, Kanda J, Uchida N, Ohno Y, Miyakoshi S, et al. Comparison of transplant outcomes from matched sibling bone marrow or peripheral blood stem cell and unrelated cord blood in patients 50 years or older. Am J Hematol. 2016;91:E284–292.
doi: 10.1002/ajh.24340
Baron F, Labopin M, Ruggeri A, Cornelissen JJ, Meijer E, Sengeloev H, et al. Impact of donor type in patients with AML given allogeneic hematopoietic cell transplantation after low-dose TBI-Based Regimen. Clin Cancer Res. 2018;24:2794–803.
doi: 10.1158/1078-0432.CCR-17-3622
Socié G, Stone JV, Wingard JR, Weisdorf D, Henslee-Downey PJ, Bredeson C, et al. Long-term survival and late deaths after allogeneic bone marrow transplantation. Late Effects Working Committee of the International Bone Marrow Transplant Registry. N Engl J Med. 1999;341:14–21.
doi: 10.1056/NEJM199907013410103
Shimoni A, Labopin M, Savani B, Byrne M, Volin L, Finke J, et al. Comparable long-term outcome after allogeneic stem cell transplantation from sibling and matched unrelated donors in patients with acute myeloid leukemia older than 50 years: a report on behalf of the acute leukemia working party of the European Society for Blood and Marrow Transplantation. Biol Blood Marrow Transpl. 2019;25:2251–60.
doi: 10.1016/j.bbmt.2019.06.031
Baron F, Ruggeri A, Beohou E, Labopin M, Mohty M, Sanz J, et al. Occurrence of graft-versus-host disease increases mortality after umbilical cord blood transplantation for acute myeloid leukaemia: a report from Eurocord and the ALWP of the EBMT. J Intern Med. 2018;283:178–89.
doi: 10.1111/joim.12696
Milano F, Gooley T, Wood B, Woolfrey A, Flowers ME, Doney K, et al. Cord-blood transplantation in patients with minimal residual disease. N Engl J Med. 2016;375:944–53.
doi: 10.1056/NEJMoa1602074
Wagner JEJ, Brunstein CG, Boitano AE, DeFor TE, McKenna D, Sumstad D, et al. Phase I/II trial of stemregenin-1 expanded umbilical cord blood hematopoietic stem cells supports testing as a stand-alone graft. Cell Stem Cell. 2016;18:144–55.
doi: 10.1016/j.stem.2015.10.004
Cohen S, Roy J, Lachance S, Delisle J-S, Marinier A, Busque L, et al. Hematopoietic stem cell transplantation using single UM171-expanded cord blood: a single-arm, phase 1-2 safety and feasibility study. Lancet Haematol. 2020;7:e134–e145.
doi: 10.1016/S2352-3026(19)30202-9
Passweg JR, Baldomero H, Chabannon C, Basak GW, Corbacioglu S, Duarte R, et al. The EBMT activity survey on hematopoietic-cell transplantation and cellular therapy 2018: CAR-T’s come into focus. Bone Marrow Transpl. 2020;55:1604–13.
doi: 10.1038/s41409-020-0826-4
Canaani J, Labopin M, Itälä-Remes M, Blaise D, Socié G, Forcade E, et al. Prognostic significance of recurring chromosomal abnormalities in transplanted patients with acute myeloid leukemia. Leukemia. 2019;33:1944–52.
doi: 10.1038/s41375-019-0439-3
Verneris MR, Brunstein CG, Barker J, MacMillan ML, DeFor T, McKenna DH, et al. Relapse risk after umbilical cord blood transplantation: enhanced graft-versus-leukemia effect in recipients of 2 units. Blood. 2009;114:4293–9.
doi: 10.1182/blood-2009-05-220525
Baron F, Labopin M, Ruggeri A, Sierra J, Robinson S, Labussière-Wallet H, et al. Impact of detectable measurable residual disease on umbilical cord blood transplantation. Am J Hematol. 2020. https://doi.org/10.1002/ajh.25879 .
Baker KS, Leisenring WM, Goodman PJ, Ermoian RP, Flowers ME, Schoch G, et al. Total body irradiation dose and risk of subsequent neoplasms following allogeneic hematopoietic cell transplantation. Blood. 2019;133:2790–9.
doi: 10.1182/blood.2018874115
Syrjala KL, Martin PJ, Lee SJ. Delivering care to long-term adult survivors of hematopoietic cell transplantation. J Clin Oncol. 2012;30:3746–51.
doi: 10.1200/JCO.2012.42.3038
Finke J, Schmoor C, Bethge WA, Ottinger H, Stelljes M, Volin L, et al. Long-term outcomes after standard graft-versus-host disease prophylaxis with or without anti-human-T-lymphocyte immunoglobulin in haemopoietic cell transplantation from matched unrelated donors: final results of a randomised controlled trial. Lancet Haematol. 2017;4:e293–e301.
doi: 10.1016/S2352-3026(17)30081-9
Bonifazi F, Solano C, Wolschke C, Sessa M, Patriarca F, Zallio F, et al. Acute GVHD prophylaxis plus ATLG after myeloablative allogeneic haemopoietic peripheral blood stem-cell transplantation from HLA-identical siblings in patients with acute myeloid leukaemia in remission: final results of quality of life and long-term outcome analysis of a phase 3 randomised study. Lancet Haematol. 2019;6:e89–e99.
doi: 10.1016/S2352-3026(18)30214-X
Baron F, Mohty M, Blaise D, Socie G, Labopin M, Esteve J, et al. Anti-thymocyte globulin as graft-versus-host disease prevention in the setting of allogeneic peripheral blood stem cell transplantation: a review from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica. 2017;102:224–34.
doi: 10.3324/haematol.2016.148510
Pascal L, Mohty M, Ruggeri A, Tucunduva L, Milpied N, Chevallier P, et al. Impact of rabbit ATG-containing myeloablative conditioning regimens on the outcome of patients undergoing unrelated single-unit cord blood transplantation for hematological malignancies. Bone Marrow Transpl. 2015;50:45–50.
doi: 10.1038/bmt.2014.216
Ringdén O, Labopin M, Ehninger G, Niederwieser D, Olsson R, Basara N, et al. Reduced intensity conditioning compared with myeloablative conditioning using unrelated donor transplants in patients with acute myeloid leukemia. J Clin Oncol. 2009;27:4570–7.
doi: 10.1200/JCO.2008.20.9692
Baron F, Ruggeri A, Beohou E, Labopin M, Sanz G, Milpied N, et al. RIC versus MAC UCBT in adults with AML: a report from Eurocord, the ALWP and the CTIWP of the EBMT. Oncotarget. 2016;7:43027–38.
doi: 10.18632/oncotarget.9599
Scott BL, Pasquini MC, Logan BR, Wu J, Devine SM, Porter DL, et al. Myeloablative versus reduced-intensity hematopoietic cell transplantation for acute myeloid leukemia and myelodysplastic syndromes. J Clin Oncol. 2017;35:1154–61.
doi: 10.1200/JCO.2016.70.7091