Haplo-Cord transplantation compared to haploidentical transplantation with post-transplant cyclophosphamide in patients with AML

Data de publicació: 01/08/2017

Autors de IIS La Fe

Pau Montesinos Fernández

Autor
Pablo Herrera Melian

Autor
Monica Torres Contell

Autor

Autors aliens a IIS La Fe

Kwon M
Bautista G
Balsalobre P
Sánchez-Ortega I
Bermúdez A
de Laiglesia A
Martin C
Humala K
Zabalza A
Bento L
Corral LL
Heras I
Serrano D
Buño I
Anguita J
Regidor C
Duarte R
Cabrera R
Gayoso J
Diez-Martin JL

Grups d'Investigació

Hematología y Hemoterapia

Investigador Principal

Javier De La Rubia Comos

Abstract

For patients with AML, the best alternative donor remains to be defined. We analyze outcomes of patients who underwent myeloablative umbilical cord blood or haploidentical hemopoietic stem cell transplantation (HSCT) in Spain. Fifty-one patients underwent single umbilical cord blood transplantation supported by a third party donor (Haplo-Cord) between 1999 and 2012, and 36 patients received an haploidentical HSCT with post-transplant cyclophosphamide (PTCY-haplo) between 2012 and 2014 in GETH centers. The Haplo-Cord cohort included a higher proportion of patients with high disease risk index and use of TBI in the conditioning regimen, and hematopoietic cell transplantation-age Comorbidity Age Index was higher in PTCY-haplo patients. Cumulative incidence of neutrophil engraftment was 97% in the Haplo-Cord and 100% in the PTCY-haplo group, achieved in a median of 12 and 17 days, respectively (P = 0.01). Grade II-IV acute GvHD rate was significantly higher in the PTCY-haplo group (9.8% vs 29%, P = 0.02) as well as chronic GvHD rates (20% vs 38%, P = 0.03). With a median follow-up of 61 months for the Haplo-Cord group and 26 months for the PTCY-haplo cohort, overall survival at 2 years was 55% and 59% (P = 0.66), event-free survival was 45% vs 56% (P = 0.46), relapse rate was 27% vs 21% (P = 0.79), and non-relapse mortality was 17% vs 23% (P = 0.54), respectively. In this multicenter experience, Haplo-Cord and PTCY-haplo HSCT offer valid alternatives for patients with AML. Neutrophil engraftment was faster in the Haplo-Cord cohort, with similar survival rates, with higher GvHD rates after haploidentical HSCT.

Dades de la publicació

ISSN/ISSNe:: 0268-3369, 1476-5365
Tipus:: Article
Pàgines:: 1138-1143
DOI:: 10.1038/bmt.2017.36
PubMed:: 28346415
Factor d'Impacte:: 1,935 SCImago ℠
Quartil:: Q1 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Kwon M:: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain

Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Bautista G:: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
Balsalobre P:: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain

Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Sánchez-Ortega I:: Department of Hematology, Hospital Duran i Reynals, Barcelona, Spain
Montesinos P:: Department of Hematology, Hospital U. La Fe, Valencia, Spain
Bermúdez A:: Department of Hematology, Hospital Universitario Marqués Valdecilla, Santander, Spain
de Laiglesia A:: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
Herrera P:: Department of Hematology, Hospital Universitario Ramon y Cajal, Madrid, Spain
Martin C:: Department of Hematology, Hospital Universitario Reina Sofia, Córdoba, Spain
Humala K:: Department of Hematology, Hospital Universitario La Paz, Madrid, Spain
Zabalza A:: Department of Hematology, Complejo Hospitalario Navarra, Pamplona, Spain
Torres M:: Department of Hematology, Hospital Universitario Gran Canaria Dr Negrin, Las Palmas, Spain
Bento L:: Department of Hematology, Hospital Universitario Son Epases, Mallorca, Spain
Corral LL:: Department of Hematology, Hospital Clínico Universitario Salamanca, Murcia, Spain
Heras I:: Department of Hematology, Hospital General Universitario Morales Meseguer, Murcia, Spain
Serrano D:: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain

Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Buño I:: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain

Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Anguita J:: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain

Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Regidor C:: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
Duarte R:: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
Cabrera R:: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
Gayoso J:: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain

Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain

Universidad Complutense de Madrid, Madrid, Spain
Diez-Martin JL:: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain

Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain

Universidad Complutense de Madrid, Madrid, Spain

Keywords

BONE-MARROW-TRANSPLANTATION; HIGH-RISK PATIENTS; BLOOD TRANSPLANTATION; DONOR TRANSPLANTATION; CELL TRANSPLANTATION; 3RD-PARTY DONOR; ACUTE-LEUKEMIA; CD34(+) CELLS; WORKING GROUP; OUTCOMES