Cargando…

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

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 misma...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306430/
https://www.ncbi.nlm.nih.gov/pubmed/37388926
http://dx.doi.org/10.1097/HS9.0000000000000920
_version_ 1785065932949815296
author 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
author_facet 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
author_sort Kharfan-Dabaja, Mohamed A.
collection PubMed
description 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.
format Online
Article
Text
id pubmed-10306430
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-103064302023-06-29 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 Hemasphere Article 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. Lippincott Williams & Wilkins 2023-06-27 /pmc/articles/PMC10306430/ /pubmed/37388926 http://dx.doi.org/10.1097/HS9.0000000000000920 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
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
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10306430/
https://www.ncbi.nlm.nih.gov/pubmed/37388926
http://dx.doi.org/10.1097/HS9.0000000000000920
work_keys_str_mv AT kharfandabajamohameda significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT labopinmyriam significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT ayalaernesto significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT bazarbachiali significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT blaisedidier significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT vydrajan significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT bramantistefania significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT italaremesmaija significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT schmidchristoph significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT buscaalessandro significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT forcadeedouard significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT rabitschwerner significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT zeccamarco significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT krogernicolaus significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT bulaboisclaudeeric significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT grillogiovanni significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT rambaldialessandro significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT faninrenato significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT zalliofrancesco significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT direnzonicola significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT kocyener significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT novisyana significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT mcdonaldandrew significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT herreraarroyoconcepcion significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT sanzjaime significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT naglerarnon significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT cicerifabio significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt
AT mohtymohamad significanceofdegreeofhladisparityusingtcellrepleteperipheralbloodstemcellsfromhaploidenticaldonorswithposttransplantationcyclophosphamideinamlinfirstcompletehematologicremissionastudyoftheacuteleukemiaworkingpartyoftheebmt