Second haploidentical stem cell transplantation (HAPLO-SCT2) after relapse from a first HAPLO-SCT in acute leukaemia-a study on behalf of the Acute Leukaemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT)
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Second haploidentical stem cell transplantation (HAPLO-SCT2) after relapse from a first HAPLO-SCT in acute leukaemia-a study on behalf of the Acute Leukaemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). / Filippini Velázquez, Giuliano; Labopin, Myriam; Tischer, Johanna; Raiola, Anna Maria; Angelucci, Emanuele; Kulagin, Alexander D; Galieni, Piero; Bermúdez, Arancha; Bulabois, Claude-Eric; Kröger, Nicolaus; Díez-Martín, José Luis; Kwon, Mi; Nagler, Arnon; Schmid, Christoph; Ciceri, Fabio; Mohty, Mohamad.
In: BONE MARROW TRANSPL, Vol. 58, No. 8, 08.2023, p. 907-915.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Second haploidentical stem cell transplantation (HAPLO-SCT2) after relapse from a first HAPLO-SCT in acute leukaemia-a study on behalf of the Acute Leukaemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT)
AU - Filippini Velázquez, Giuliano
AU - Labopin, Myriam
AU - Tischer, Johanna
AU - Raiola, Anna Maria
AU - Angelucci, Emanuele
AU - Kulagin, Alexander D
AU - Galieni, Piero
AU - Bermúdez, Arancha
AU - Bulabois, Claude-Eric
AU - Kröger, Nicolaus
AU - Díez-Martín, José Luis
AU - Kwon, Mi
AU - Nagler, Arnon
AU - Schmid, Christoph
AU - Ciceri, Fabio
AU - Mohty, Mohamad
N1 - © 2023. The Author(s).
PY - 2023/8
Y1 - 2023/8
N2 - For patients with acute myeloid and lymphoblastic leukaemia (AML/ALL) lacking a matched sibling or unrelated donor, haploidentical stem cell transplantation (HAPLO-SCT) is increasingly used. However, available data on the treatment of relapse after HAPLO-SCT, including feasibility and efficacy of a second HAPLO-SCT (HAPLO-SCT2), is scarce. Hence, adults with AML/ALL, that had undergone HAPLO-SCT2 without ex-vivo manipulation after haematologic relapse from HAPLO-SCT1 were selected for a retrospective registry analysis. Eighty-two patients (AML, n = 63, ALL, n = 19, median follow-up: 33 months) were identified. Engraftment rate was 87%. At day +180, cumulative incidences of acute GvHD II-IV°/chronic GvHD were 23.9%/22.6%, respectively. Two-year overall survival/leukaemia-free survival (OS/LFS) were 34.3%/25.4%; 2-year non-relapse mortality (NRM) and relapse incidence (RI) were 17.6% and 57%. Leukaemia was the most frequent cause of death. Separated by disease, 2-year OS/LFS/NRM/RI were 28.7%/22.3%/16.2%/61.6% in AML, and 55.3%/38.4%/23.5%/38.2% in ALL patients. In a risk-factor analysis among patients with AML, stage at HAPLO-SCT1 and HAPLO-SCT2, and interval from HAPLO-SCT1 to relapse significantly influenced outcome. Our data demonstrate that HAPLO-SCT2 is a viable option in acute leukaemia relapse after HAPLO-SCT1. Engraftment, toxicity, risk factors and long-term outcome are comparable to data reported after allo-SCT2 in a matched donor setting.
AB - For patients with acute myeloid and lymphoblastic leukaemia (AML/ALL) lacking a matched sibling or unrelated donor, haploidentical stem cell transplantation (HAPLO-SCT) is increasingly used. However, available data on the treatment of relapse after HAPLO-SCT, including feasibility and efficacy of a second HAPLO-SCT (HAPLO-SCT2), is scarce. Hence, adults with AML/ALL, that had undergone HAPLO-SCT2 without ex-vivo manipulation after haematologic relapse from HAPLO-SCT1 were selected for a retrospective registry analysis. Eighty-two patients (AML, n = 63, ALL, n = 19, median follow-up: 33 months) were identified. Engraftment rate was 87%. At day +180, cumulative incidences of acute GvHD II-IV°/chronic GvHD were 23.9%/22.6%, respectively. Two-year overall survival/leukaemia-free survival (OS/LFS) were 34.3%/25.4%; 2-year non-relapse mortality (NRM) and relapse incidence (RI) were 17.6% and 57%. Leukaemia was the most frequent cause of death. Separated by disease, 2-year OS/LFS/NRM/RI were 28.7%/22.3%/16.2%/61.6% in AML, and 55.3%/38.4%/23.5%/38.2% in ALL patients. In a risk-factor analysis among patients with AML, stage at HAPLO-SCT1 and HAPLO-SCT2, and interval from HAPLO-SCT1 to relapse significantly influenced outcome. Our data demonstrate that HAPLO-SCT2 is a viable option in acute leukaemia relapse after HAPLO-SCT1. Engraftment, toxicity, risk factors and long-term outcome are comparable to data reported after allo-SCT2 in a matched donor setting.
KW - Adult
KW - Humans
KW - Retrospective Studies
KW - Bone Marrow
KW - Neoplasm Recurrence, Local
KW - Leukemia, Myeloid, Acute/genetics
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Acute Disease
KW - Graft vs Host Disease/etiology
KW - Unrelated Donors
KW - Transplantation Conditioning/adverse effects
U2 - 10.1038/s41409-023-01985-7
DO - 10.1038/s41409-023-01985-7
M3 - SCORING: Journal article
C2 - 37160941
VL - 58
SP - 907
EP - 915
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 8
ER -
