Previous observations have reported controversial conclusions regarding cell dose and survival endpoints after allogeneic hematopoietic stem cell transplantation (HSCT). We conducted a retrospective analysis on 414 adult patients (median age 54 years, range, 18-74) with acute myeloid leukemia (AML) in first and second complete remission who received a T-cell replete allogeneic HSCT from haploidentical donors, using peripheral blood stem cells, between 2006-2018. Median number of infused CD34+ was 6.58 x 106 /kg (range, 2.2-31.2). Graft-versus-host disease (GVHD) prophylaxis was post-transplant cyclophosphamide in 293 patients and anti-lymphocyte serum in 121 patients. Conditioning was myeloablative in 179 patients and reduced-intensity in 235 patients. After a median follow-up of 23.3 months (range, 12.1-41.8), 2-year overall survival (OS) was 64.5 % (95% CI 59.3-69.7) with leukemia-free survival (LFS) of 57.3 % (95% CI 51.8-62.7) and non-relapse mortality (NRM) of 23.3 % (95% CI 19-27.7). Grades III-IV acute GVHD day+100 incidence was 14.6 % while extensive chronic GVHD was 14.4% at 2-years. Thirteen (3.2%) patients experienced graft failure. We found the optimal CD34+/kg threshold defining high (n= 334) versus low cell dose (n= 80) at 4.96 x 106 . Recipients of > 4.96 x 106 /kg CD34+ cells experienced less NRM (Hazard ratio [HR] 0.48; 95% CI 0.30-0.76) and prolonged LFS (HR 0.63; 95% CI 0.43-0.91) and OS (HR 0.60; 95% CI 0.40-0.88) compared to those in the lower cell dose cohort. Larger cohort studies are needed to confirm these findings.

CD34+ cell dose effects on clinical outcomes after T-cell replete haploidentical allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia using peripheral blood stem cells. A Study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) / Maffini, Enrico; Labopin, Myriam; Blaise, Didier; Ciceri, Fabio; Gülbas, Zafer; Deconinck, Eric; Leblond, Veronique; Chevallier, Patrick; Sociè, Gerard; Araujo, Mercedes Colorado; Koc, Yener; Savani, Bipin N; Gorin, Norbert Claude; Lanza, Francesco; Nagler, Arnon; Mohty, Mohamad. - In: AMERICAN JOURNAL OF HEMATOLOGY. - ISSN 0361-8609. - STAMPA. - 95:8(2020), pp. 892-899. [10.1002/ajh.25826]

CD34+ cell dose effects on clinical outcomes after T-cell replete haploidentical allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia using peripheral blood stem cells. A Study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

Lanza, Francesco
Penultimo
Supervision
;
2020

Abstract

Previous observations have reported controversial conclusions regarding cell dose and survival endpoints after allogeneic hematopoietic stem cell transplantation (HSCT). We conducted a retrospective analysis on 414 adult patients (median age 54 years, range, 18-74) with acute myeloid leukemia (AML) in first and second complete remission who received a T-cell replete allogeneic HSCT from haploidentical donors, using peripheral blood stem cells, between 2006-2018. Median number of infused CD34+ was 6.58 x 106 /kg (range, 2.2-31.2). Graft-versus-host disease (GVHD) prophylaxis was post-transplant cyclophosphamide in 293 patients and anti-lymphocyte serum in 121 patients. Conditioning was myeloablative in 179 patients and reduced-intensity in 235 patients. After a median follow-up of 23.3 months (range, 12.1-41.8), 2-year overall survival (OS) was 64.5 % (95% CI 59.3-69.7) with leukemia-free survival (LFS) of 57.3 % (95% CI 51.8-62.7) and non-relapse mortality (NRM) of 23.3 % (95% CI 19-27.7). Grades III-IV acute GVHD day+100 incidence was 14.6 % while extensive chronic GVHD was 14.4% at 2-years. Thirteen (3.2%) patients experienced graft failure. We found the optimal CD34+/kg threshold defining high (n= 334) versus low cell dose (n= 80) at 4.96 x 106 . Recipients of > 4.96 x 106 /kg CD34+ cells experienced less NRM (Hazard ratio [HR] 0.48; 95% CI 0.30-0.76) and prolonged LFS (HR 0.63; 95% CI 0.43-0.91) and OS (HR 0.60; 95% CI 0.40-0.88) compared to those in the lower cell dose cohort. Larger cohort studies are needed to confirm these findings.
2020
CD34+ cell dose effects on clinical outcomes after T-cell replete haploidentical allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia using peripheral blood stem cells. A Study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) / Maffini, Enrico; Labopin, Myriam; Blaise, Didier; Ciceri, Fabio; Gülbas, Zafer; Deconinck, Eric; Leblond, Veronique; Chevallier, Patrick; Sociè, Gerard; Araujo, Mercedes Colorado; Koc, Yener; Savani, Bipin N; Gorin, Norbert Claude; Lanza, Francesco; Nagler, Arnon; Mohty, Mohamad. - In: AMERICAN JOURNAL OF HEMATOLOGY. - ISSN 0361-8609. - STAMPA. - 95:8(2020), pp. 892-899. [10.1002/ajh.25826]
Maffini, Enrico; Labopin, Myriam; Blaise, Didier; Ciceri, Fabio; Gülbas, Zafer; Deconinck, Eric; Leblond, Veronique; Chevallier, Patrick; Sociè, Gerard; Araujo, Mercedes Colorado; Koc, Yener; Savani, Bipin N; Gorin, Norbert Claude; Lanza, Francesco; Nagler, Arnon; Mohty, Mohamad
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/917952
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