Title |
Haploidentical transplantation is associated with better overall survival when compared to single cord blood transplantation: an EBMT-Eurocord study of acute leukemia patients conditioned with thiotepa, busulfan, and fludarabine
|
---|---|
Published in |
Journal of Hematology & Oncology, August 2018
|
DOI | 10.1186/s13045-018-0655-8 |
Pubmed ID | |
Authors |
Federica Giannotti, Myriam Labopin, Roni Shouval, Jaime Sanz, William Arcese, Emanuele Angelucci, Jorge Sierra, Josep-Maria Ribera Santasusana, Stella Santarone, Bruno Benedetto, Alessandro Rambaldi, Riccardo Saccardi, Didier Blaise, Michele Angelo Carella, Vanderson Rocha, Frederic Baron, Mohamad Mohty, Annalisa Ruggeri, Arnon Nagler |
Abstract |
Thiotepa-busulfan-fludarabine (TBF) is a widely used conditioning regimen in single umbilical cord blood transplantation (SUCBT). More recently, it was introduced in the setting of non-T cell depleted haploidentical stem cell transplantation (NTD-Haplo). Whether TBF based conditioning provides additional benefit in transplantation from a particular alternative donor type remains to be established. This was a retrospective study based on an international European registry. We compared outcomes of de-novo acute myeloid leukemia patients in complete remission receiving NTD-Haplo (n = 186) vs. SUCBT (n = 147) following myeloablative conditioning (MAC) with TBF. Median follow-up was 23 months. Treatment groups resembled in baseline characteristics. SUCBT was associated with delayed engraftment and higher graft failure. In multivariate analysis no statistically significant differences were observed between the two groups in terms of acute or chronic graft-versus-host disease (GvHD) (HR = 1.03, p = 0.92 or HR = 1.86, p = 0.21) and relapse incidence (HR = 0.8, p = 0.65). Non-relapse mortality (NRM) was significantly higher in SUCBT as compared to NTD-Haplo (HR = 2.63, p = 0.001); moreover, SUCBT did worse in terms of overall survival (HR = 2.18, p = 0.002), leukemia-free survival (HR = 1.94, p = 0.007), and GvHD relapse-free survival (HR = 2.38, p = 0.0002). Our results suggest that TBF-MAC might allow for a potent graft-versus-leukemia, regardless of the alternative donor type. Furthermore, in patients receiving TBF-MAC, survival with NTD-Haplo may be better compared to SUCBT due to decreased NRM. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 4 | 36% |
France | 2 | 18% |
Russia | 1 | 9% |
Mexico | 1 | 9% |
United Kingdom | 1 | 9% |
United States | 1 | 9% |
Unknown | 1 | 9% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 8 | 73% |
Practitioners (doctors, other healthcare professionals) | 2 | 18% |
Scientists | 1 | 9% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 34 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 6 | 18% |
Student > Doctoral Student | 3 | 9% |
Student > Bachelor | 3 | 9% |
Student > Ph. D. Student | 2 | 6% |
Student > Postgraduate | 2 | 6% |
Other | 10 | 29% |
Unknown | 8 | 24% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 15 | 44% |
Immunology and Microbiology | 4 | 12% |
Economics, Econometrics and Finance | 1 | 3% |
Unspecified | 1 | 3% |
Psychology | 1 | 3% |
Other | 1 | 3% |
Unknown | 11 | 32% |