Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT
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Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT. / Kharfan-Dabaja, Mohamed A; Labopin, Myriam; Ayala, Ernesto; Bazarbachi, Ali; Blaise, Didier; Vydra, Jan; Bramanti, Stefania; Itälä-Remes, Maija; Schmid, Christoph; Busca, Alessandro; Forcade, Edouard; Rabitsch, Werner; Zecca, Marco; Kröger, Nicolaus; Bulabois, Claude-Eric; Grillo, Giovanni; Rambaldi, Alessandro; Fanin, Renato; Zallio, Francesco; Di Renzo, Nicola; Koc, Yener; Novis, Yana; McDonald, Andrew; Herrera Arroyo, Concepcion; Sanz, Jaime; Nagler, Arnon; Ciceri, Fabio; Mohty, Mohamad.
In: HEMASPHERE, Vol. 7, No. 7, 07.2023, p. e920.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT
AU - Kharfan-Dabaja, Mohamed A
AU - Labopin, Myriam
AU - Ayala, Ernesto
AU - Bazarbachi, Ali
AU - Blaise, Didier
AU - Vydra, Jan
AU - Bramanti, Stefania
AU - Itälä-Remes, Maija
AU - Schmid, Christoph
AU - Busca, Alessandro
AU - Forcade, Edouard
AU - Rabitsch, Werner
AU - Zecca, Marco
AU - Kröger, Nicolaus
AU - Bulabois, Claude-Eric
AU - Grillo, Giovanni
AU - Rambaldi, Alessandro
AU - Fanin, Renato
AU - Zallio, Francesco
AU - Di Renzo, Nicola
AU - Koc, Yener
AU - Novis, Yana
AU - McDonald, Andrew
AU - Herrera Arroyo, Concepcion
AU - Sanz, Jaime
AU - Nagler, Arnon
AU - Ciceri, Fabio
AU - Mohty, Mohamad
N1 - Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.
PY - 2023/7
Y1 - 2023/7
N2 - Availability of haploidentical donors has broadened utilization of allogeneic hematopoietic cell transplantation (allo-HCT). Peripheral blood stem cells (PBSC) are being used with increased frequency in haploidentical allo-HCT. We evaluated extent of HLA disparity (2-3/8 versus 4/8 HLA antigen mismatches) on post-allograft outcomes when using T-cell replete PBSC from haploidentical donors for acute myeloid leukemia in first complete remission. Primary objectives entailed assessing cumulative incidence of grade 2-4 acute graft-versus-host disease (GVHD) and chronic GVHD (any grade). A total of 645 patients received a haploidentical allo-HCT from a donor with either 2-3 of 8 HLA antigen mismatches (n = 180) or with 4 of 8 HLA antigen mismatches (n = 465). Presence of 2-3 of 8 versus 4 of 8 HLA mismatches did not affect the incidence of acute GVHD (grade 2-4) and chronic GVHD (any grade). Overall survival (OS), leukemia-free survival (LFS) relapse incidence (RI), nonrelapse mortality and the composite endpoint of GVHD-free relapse-free survival were also similar among the groups. Pertaining to HLA-B leader matching effect, our analysis did not discern any difference in aforementioned post-allograft outcomes for this variable. However, in univariate analysis, absence of an antigen mismatch in HLA-DPB1 showed a trend for better OS. Notwithstanding inherent limitations associated with registry data, our results did not show an advantage of selecting a haploidentical donor with 2-3 of 8 HLA antigen mismatches over one with 4 of 8 HLA antigen mismatches when using PBSC as the cell source. Adverse cytogenetics remains a major adverse determinant of inferior OS and LFS and a higher RI. Using reduced-intensity conditioning yielded worse OS and LFS.
AB - Availability of haploidentical donors has broadened utilization of allogeneic hematopoietic cell transplantation (allo-HCT). Peripheral blood stem cells (PBSC) are being used with increased frequency in haploidentical allo-HCT. We evaluated extent of HLA disparity (2-3/8 versus 4/8 HLA antigen mismatches) on post-allograft outcomes when using T-cell replete PBSC from haploidentical donors for acute myeloid leukemia in first complete remission. Primary objectives entailed assessing cumulative incidence of grade 2-4 acute graft-versus-host disease (GVHD) and chronic GVHD (any grade). A total of 645 patients received a haploidentical allo-HCT from a donor with either 2-3 of 8 HLA antigen mismatches (n = 180) or with 4 of 8 HLA antigen mismatches (n = 465). Presence of 2-3 of 8 versus 4 of 8 HLA mismatches did not affect the incidence of acute GVHD (grade 2-4) and chronic GVHD (any grade). Overall survival (OS), leukemia-free survival (LFS) relapse incidence (RI), nonrelapse mortality and the composite endpoint of GVHD-free relapse-free survival were also similar among the groups. Pertaining to HLA-B leader matching effect, our analysis did not discern any difference in aforementioned post-allograft outcomes for this variable. However, in univariate analysis, absence of an antigen mismatch in HLA-DPB1 showed a trend for better OS. Notwithstanding inherent limitations associated with registry data, our results did not show an advantage of selecting a haploidentical donor with 2-3 of 8 HLA antigen mismatches over one with 4 of 8 HLA antigen mismatches when using PBSC as the cell source. Adverse cytogenetics remains a major adverse determinant of inferior OS and LFS and a higher RI. Using reduced-intensity conditioning yielded worse OS and LFS.
U2 - 10.1097/HS9.0000000000000920
DO - 10.1097/HS9.0000000000000920
M3 - SCORING: Journal article
C2 - 37388926
VL - 7
SP - e920
JO - HEMASPHERE
JF - HEMASPHERE
SN - 2572-9241
IS - 7
ER -
