Page 81 - Haematologica August 2018

Acute Myeloid Leukemia
Outcomes of hematopoietic stem cell transplantation from unmanipulated haploidentical versus matched sibling donor in patients with acute myeloid leukemia in first complete remission with intermediate or high-risk cytogenetics: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Dalila Salvatore,1,2 Myriam Labopin,1,3,4 Annalisa Ruggeri,1,5
Giorgia Battipaglia,1,2 Ardeshir Ghavamzadeh,6 Fabio Ciceri,7 Didier Blaise,8 William Arcese,9 Gerard Sociè,10 Jean Henri Bourhis,11 Maria Teresa Van Lint,12 Benedetto Bruno,13 Anne Huynh,14 Stella Santarone,15 Eric Deconinck,16 Mohamad Mohty1,3,4 and Arnon Nagler4,17
1Service d'Hématologie et Thérapie Cellulaire Hôpital Saint Antoine, Paris, France; 2Hematology Department, Federico II University, Naples, Italy; 3Hospital Saint-Antoine, Paris University UPMC, France; 4Acute Leukemia Working Party of EBMT, Paris, France; 5Department of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children's Hospital, Roma, Italy; 6Shariati Hospital, Hematology-Oncology and BMT Research, Teheran, Iran; 7Haematology and BMT Unit, IRCCS Ospedale San Raffaele, Milano, Italy; 8Programme de Transplantation &Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, France; 9Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy; 10Hopital St. Louis, Dept.of Hematology – BMT, Paris, France; 11Hematology department, Institut Gustave Roussy, Villejuif, France; 12Ospedale San Martino, Department of Haematology II Genova; 13A.O.U. Città della Salute e della Scienza, Torino, Italy; 14Institut Universitaire du Cancer Toulouse, Oncopole, France; 15Unità Terapia Intensiva Ematologica per il Trapianto Emopoietico, Ospedale Civile, Pescara, Italia; 16Hopital Jean Minjoz, Service d'Hématologie, Besançon, France and 17Chaim Sheba Medical Center, Tel-Hashomer, Israel
ABSTRACT
Allogeneic hematopoietic stem cell transplantation is the optimal care for patients with high-risk or intermediate - acute myeloid leukemia. In patients lacking matched sibling donor, haploiden- tical donors are an option. We compared outcomes of unmanipulated (Haplo) to matched sibling donor transplant in acute myeloid leukemia patients in first complete remission. Included were intermediate and high-risk acute myeloid leukemia in first complete remission undergo- ing Haplo and matched sibling donor transplant from 2007-2015, and reported to the ALWP of the EBMT. A propensity score technique was used to confirm results of main analysis: 2 matched sibling donors were matched with 1 Haplo. We identified 2654 pts (Haplo =185; matched sibling donor =2469), 2010 with intermediate acute myeloid leukemia (Haplo=122; matched sibling donor =1888) and 644 with high-risk acute myeloid leukemia (Haplo =63; matched sibling donor =581). Median follow up was 30 (range 1-116) months. In multivariate analysis, in intermediate - acute myeloid leukemia patients, Haplo resulted in lower leukemia-free survival (Hazard Ratio 1.74; P<0.01), overall-survival (HR 1.80; P<0.01) and GvHD-free-relapse-free survival (Hazard Ratio 1.32; P<0.05) and higher graft-versus-host disease (GvHD) non-relapse mortality (Hazard Ratio 3.03; P<0.01) as com- pared to matched sibling donor. In high-risk acute myeloid leukemia, no differences were found in leukemia-free survival, overall-survival, and GvHD-free- relapse-free survival according to donor type. Higher
Ferrata Storti Foundation
Haematologica 2018 Volume 103(8):1317-1328
Correspondence:
annalisaruggeri80@hotmail.com
Received: January 22, 2018. Accepted: May 10, 2018. Pre-published: May 10, 2018.
doi:10.3324/haematol.2018.189258
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/103/8/1317
©2018 Ferrata Storti Foundation
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