Non-T-depleted haploidentical transplantation with post-transplant cyclophosphamide in patients with secondary versus de novo AML in first complete remission: a study from the ALWP/EBMT.
De novo acute myeloid leukemia
Haploidentical allogeneic stem cell transplantation
Post-transplantation cyclophosphamide
Secondary acute myeloid leukemia
Transplantation outcomes
Journal
Journal of hematology & oncology
ISSN: 1756-8722
Titre abrégé: J Hematol Oncol
Pays: England
ID NLM: 101468937
Informations de publication
Date de publication:
29 05 2023
29 05 2023
Historique:
received:
09
01
2023
accepted:
10
05
2023
medline:
31
5
2023
pubmed:
30
5
2023
entrez:
29
5
2023
Statut:
epublish
Résumé
We compared outcomes of adult patients with secondary acute myeloid leukemia (sAML) versus de novo AML after non-T-depleted haploidentical stem cell transplant (HaploSCT) with post-transplant cyclophosphamide (PTCy). Seventeen hundred and eleven AML patients (sAML-231, de novo-1480) in first complete remission transplanted from 2010 to 2021, were included. Patients with de novo AML were younger, median age 55.8 versus 60.8 years, p < 0.0001, had better transplantation comorbidity index (HCT-CI) ≥ 3 21.3% versus 40.8%, p < 0.0001 and Karnofsky performance status (KPS) with KPS ≥ 90 in 78% versus 68.5%, respectively, p = 0.002. The two patient groups did not differ with respect to gender, cytomegalovirus serostatus, and cell source. Median time from diagnosis to HaploSCT was 5.2 versus 4.9 months, respectively, p = 0.005. Fewer sAML patients received myeloablative conditioning 35.1% versus 50.1%, p < 0.0001. Two hundred and eleven sAML and 410 de novo AML patients were included in the matched-pair analysis matching two de novo AML with each sAML. No significant difference was observed in any transplantation outcome parameter between the sAML versus de novo AML groups. Two-year non-relapse mortality and relapse incidence did not differ with HaploSCT for de novo versus sAML; 21.4% versus 21%, hazard ratio (HR) = 0.98, p = 0.9 and 23.4% versus 20.6%, HR = 0.92, p = 0.67, respectively. Two-year leukemia-free survival, overall survival, and graft-versus-host disease (GVHD)-free, relapse-free survival were also not different between the de novo AML and sAML groups 55.2% versus 58.4%, HR = 0.95, p = 0.67; 61.4% versus 66.4%, HR = 0.91, p = 0.51 and 46.3% versus 48.2%, HR = 0.92, p = 0.48, respectively. Similarly, the incidence of engraftment as well as acute and chronic GVHD was similar between the 2 cohorts. In conclusion, HaploSCT with PTCy may be able to overcome the bad prognosis of sAML as results are not significantly different to those of HaploSCT in de novo AML.
Identifiants
pubmed: 37248463
doi: 10.1186/s13045-023-01450-4
pii: 10.1186/s13045-023-01450-4
pmc: PMC10226209
doi:
Substances chimiques
Cyclophosphamide
8N3DW7272P
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
58Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2023. The Author(s).
Références
Sci Bull (Beijing). 2022 Oct 15;67(19):1921-1924
pubmed: 36546194
Blood Cancer J. 2020 Mar 3;10(3):26
pubmed: 32127519
Am J Hematol. 2018 Jun;93(6):769-777
pubmed: 29536560
Am J Med. 1980 Aug;69(2):204-17
pubmed: 6996481
Bone Marrow Transplant. 1995 Jun;15(6):825-8
pubmed: 7581076
Biol Blood Marrow Transplant. 2011 Jun;17(6):821-30
pubmed: 20831895
Blood Adv. 2018 Aug 28;2(16):2127-2135
pubmed: 30143527
Blood. 2015 May 7;125(19):3024-31
pubmed: 25814532
Biol Blood Marrow Transplant. 2009 Dec;15(12):1628-33
pubmed: 19896087
Haematologica. 2018 Feb;103(2):237-245
pubmed: 29101205
Lancet Haematol. 2021 Jul;8(7):e481-e491
pubmed: 34171279
Biol Blood Marrow Transplant. 2019 Sep;25(9):1770-1778
pubmed: 31176789
Biol Blood Marrow Transplant. 2020 Feb;26(2):230-241
pubmed: 31586477
Blood. 2011 Feb 17;117(7):2137-45
pubmed: 21127174
Transplant Cell Ther. 2022 Nov;28(11):773.e1-773.e8
pubmed: 36031079
Biol Blood Marrow Transplant. 2018 Jul;24(7):1406-1414
pubmed: 29678639
J Hematol Oncol. 2020 May 6;13(1):46
pubmed: 32375860
Zhonghua Xue Ye Xue Za Zhi. 2018 Jul 14;39(7):546-551
pubmed: 30122012
Clin Cancer Res. 2020 Dec 15;26(24):6475-6482
pubmed: 32988970
Bone Marrow Transplant. 2022 Dec;57(12):1788-1796
pubmed: 36114249
Leuk Res. 2013 Aug;37(8):857-8
pubmed: 23664172
Bone Marrow Transplant. 2019 Dec;54(12):1987-1994
pubmed: 31150016
Stat Med. 1999 Jun 30;18(12):1489-500
pubmed: 10398287
Leukemia. 2020 May;34(5):1433-1443
pubmed: 31831845
J Clin Oncol. 2015 Nov 1;33(31):3641-9
pubmed: 26304885
J Clin Oncol. 2015 Oct 1;33(28):3152-61
pubmed: 26261255
Stat Med. 2013 Aug 30;32(19):3388-414
pubmed: 23508673
Clin Hematol Int. 2019 Dec 17;2(1):2-4
pubmed: 34595436
Blood. 2017 Apr 27;129(17):2347-2358
pubmed: 28223278
Haematologica. 2018 Aug;103(8):1317-1328
pubmed: 29748438
Int J Mol Sci. 2020 Sep 27;21(19):
pubmed: 32992663
Cancer. 2017 Aug 15;123(16):3050-3060
pubmed: 28387922
Blood. 2010 Mar 4;115(9):1850-7
pubmed: 20032503
Biol Blood Marrow Transplant. 2020 Aug;26(8):1543-1551
pubmed: 32320746
Cell Mol Immunol. 2021 May;18(5):1172-1185
pubmed: 33408344
Blood. 2015 Aug 20;126(8):1033-40
pubmed: 26130705
Blood. 2019 Sep 12;134(11):892-899
pubmed: 31270102
J Clin Oncol. 2017 Apr 10;35(11):1154-1161
pubmed: 28380315
Cancer. 2020 Mar 1;126(5):1004-1015
pubmed: 31774557
Bone Marrow Transplant. 2022 Jul;57(7):1116-1123
pubmed: 35501565
J Clin Invest. 2019 Mar 26;129(6):2357-2373
pubmed: 30913039
Clin Cancer Res. 2021 Feb 1;27(3):843-851
pubmed: 33148668
Curr Hematol Malig Rep. 2021 Feb;16(1):97-111
pubmed: 33609248
Blood Res. 2013 Sep;48(3):185-92
pubmed: 24086938
Curr Treat Options Oncol. 2015 Aug;16(8):37
pubmed: 26143266
J Hematol Oncol. 2017 Jul 4;10(1):134
pubmed: 28676064
J Clin Oncol. 2001 Mar 1;19(5):1405-13
pubmed: 11230485
Bone Marrow Transplant. 2016 Apr;51(4):610-1
pubmed: 26657834
Am J Hematol. 2015 Mar;90(3):208-14
pubmed: 25421221