TY - JOUR
T1 - Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia
AU - Wieduwilt, Matthew J.
AU - Metheny, Leland
AU - Zhang, Mei Jie
AU - Wang, Hai Lin
AU - Estrada-Merly, Noel
AU - Marks, David I.
AU - Samer Al-Homsi, A.
AU - Muffly, Lori
AU - Chao, Nelson
AU - Rizzieri, David
AU - Gale, Robert Peter
AU - Gadalla, Shahinaz M.
AU - Cairo, Mitchell
AU - Mussetti, Alberto
AU - Gore, Steven
AU - Bhatt, Vijaya Raj
AU - Patel, Sagar S.
AU - Michelis, Fotios V.
AU - Inamoto, Yoshihiro
AU - Badawy, Sherif M.
AU - Copelan, Edward
AU - Palmisiano, Neil
AU - Kharfan-Dabaja, Mohamed A.
AU - Lazarus, Hillard M.
AU - Ganguly, Siddhartha
AU - Bredeson, Christopher
AU - Perez, Miguel Angel Diaz
AU - Cassaday, Ryan
AU - Savani, Bipin N.
AU - Ballen, Karen
AU - Martino, Rodrigo
AU - Wirk, Baldeep
AU - Bacher, Ulrike
AU - Aljurf, Mahmoud
AU - Bashey, Asad
AU - Murthy, Hemant S.
AU - Yared, Jean A.
AU - Aldoss, Ibrahim
AU - Farhadfar, Nosha
AU - Liu, Hongtao
AU - Abdel-Azim, Hisham
AU - Waller, Edmund K.
AU - Solh, Melhem
AU - Seftel, Matthew D.
AU - van der Poel, Marjolein
AU - Grunwald, Michael R.
AU - Liesveld, Jane L.
AU - Kamble, Rammurti T.
AU - McGuirk, Joseph
AU - Munker, Reinhold
AU - Cahn, Jean Yves
AU - Lee, Jong Wook
AU - Freytes, Cesar O.
AU - Krem, Maxwell M.
AU - Winestone, Lena E.
AU - Gergis, Usama
AU - Nathan, Sunita
AU - Olsson, Richard F.
AU - Verdonck, Leo F.
AU - Sharma, Akshay
AU - Ringden, Olle
AU - Friend, Brian D.
AU - Cerny, Jan
AU - Choe, Hannah
AU - Chhabra, Saurabh
AU - Nishihori, Taiga
AU - Seo, Sachiko
AU - George, Biju
AU - Baxter-Lowe, Lee Ann
AU - Hildebrandt, Gerhard C.
AU - de Lima, Marcos
AU - Litzow, Mark
AU - Kebriaei, Partow
AU - Hourigan, Christopher S.
AU - Abid, Muhammad Bilal
AU - Weisdorf, Daniel J.
AU - Saber, Wael
N1 - © 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.
PY - 2022/1/11
Y1 - 2022/1/11
N2 - The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.
AB - The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.
KW - Fetal Blood
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Humans
KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy
KW - Retrospective Studies
KW - Siblings
KW - Unrelated Donors
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U2 - 10.1182/bloodadvances.2021004916
DO - 10.1182/bloodadvances.2021004916
M3 - Article
C2 - 34547770
AN - SCOPUS:85123008568
SN - 2473-9529
VL - 6
SP - 339
EP - 357
JO - Blood Advances
JF - Blood Advances
IS - 1
ER -