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Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor?

We sought to study whether survival after haploidentical transplantation is comparable to that after matched unrelated donor transplantation for 822 patients aged 50-75 years with acute myeloid leukemia in first or second complete remission. One hundred and ninety-two patients received grafts from h...

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Autores principales: Perales, Miguel-Angel, Tomlinson, Benjamin, Zhang, Mei-Jie, St. Martin, Andrew, Beitinjaneh, Amer, Gibson, John, Hogan, William, Kekre, Natasha, Lazarus, Hillard, Marks, David, McGuirk, Joseph, Romee, Rizwan, Solh, Melhem, Wagner, John E., Weisdorf, Daniel J., de Lima, Marcos, Eapen, Mary
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ferrata Storti Foundation 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012481/
https://www.ncbi.nlm.nih.gov/pubmed/31101756
http://dx.doi.org/10.3324/haematol.2018.215202
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author Perales, Miguel-Angel
Tomlinson, Benjamin
Zhang, Mei-Jie
St. Martin, Andrew
Beitinjaneh, Amer
Gibson, John
Hogan, William
Kekre, Natasha
Lazarus, Hillard
Marks, David
McGuirk, Joseph
Romee, Rizwan
Solh, Melhem
Wagner, John E.
Weisdorf, Daniel J.
de Lima, Marcos
Eapen, Mary
author_facet Perales, Miguel-Angel
Tomlinson, Benjamin
Zhang, Mei-Jie
St. Martin, Andrew
Beitinjaneh, Amer
Gibson, John
Hogan, William
Kekre, Natasha
Lazarus, Hillard
Marks, David
McGuirk, Joseph
Romee, Rizwan
Solh, Melhem
Wagner, John E.
Weisdorf, Daniel J.
de Lima, Marcos
Eapen, Mary
author_sort Perales, Miguel-Angel
collection PubMed
description We sought to study whether survival after haploidentical transplantation is comparable to that after matched unrelated donor transplantation for 822 patients aged 50-75 years with acute myeloid leukemia in first or second complete remission. One hundred and ninety-two patients received grafts from haploidentical donors (sibling 25%; offspring 75%) and 631 patients from matched unrelated donors aged 18-40 years. Patients’ and disease characteristics of the two groups were similar except that recipients of matched unrelated donor transplantation were more likely to have poor risk cytogenetics and more likely to receive myeloablative conditioning regimens. Time from documented remission to transplant did not differ by donor type. Five-year overall survival was 32% and 42% after haploidentical and matched unrelated donor transplant, respectively (P=0.04). Multivariable analysis showed higher mortality (hazard ratio 1.27, P=0.04) and relapse (hazard ratio 1.32, P=0.04) after haploidentical transplantation, with similar non-relapse mortality risks. Chronic graft-versus-host disease was higher after matched unrelated donor compared to haploidentical transplantation when bone marrow was the graft (hazard ratio 3.12, P<0.001), but when the graft was peripheral blood, there was no difference in the risk of chronic graft-versus-host disease between donor types. These data support the view that matched unrelated donor transplant with donors younger than 40 years is to be preferred.
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spelling pubmed-70124812020-02-20 Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor? Perales, Miguel-Angel Tomlinson, Benjamin Zhang, Mei-Jie St. Martin, Andrew Beitinjaneh, Amer Gibson, John Hogan, William Kekre, Natasha Lazarus, Hillard Marks, David McGuirk, Joseph Romee, Rizwan Solh, Melhem Wagner, John E. Weisdorf, Daniel J. de Lima, Marcos Eapen, Mary Haematologica Article We sought to study whether survival after haploidentical transplantation is comparable to that after matched unrelated donor transplantation for 822 patients aged 50-75 years with acute myeloid leukemia in first or second complete remission. One hundred and ninety-two patients received grafts from haploidentical donors (sibling 25%; offspring 75%) and 631 patients from matched unrelated donors aged 18-40 years. Patients’ and disease characteristics of the two groups were similar except that recipients of matched unrelated donor transplantation were more likely to have poor risk cytogenetics and more likely to receive myeloablative conditioning regimens. Time from documented remission to transplant did not differ by donor type. Five-year overall survival was 32% and 42% after haploidentical and matched unrelated donor transplant, respectively (P=0.04). Multivariable analysis showed higher mortality (hazard ratio 1.27, P=0.04) and relapse (hazard ratio 1.32, P=0.04) after haploidentical transplantation, with similar non-relapse mortality risks. Chronic graft-versus-host disease was higher after matched unrelated donor compared to haploidentical transplantation when bone marrow was the graft (hazard ratio 3.12, P<0.001), but when the graft was peripheral blood, there was no difference in the risk of chronic graft-versus-host disease between donor types. These data support the view that matched unrelated donor transplant with donors younger than 40 years is to be preferred. Ferrata Storti Foundation 2020-02 /pmc/articles/PMC7012481/ /pubmed/31101756 http://dx.doi.org/10.3324/haematol.2018.215202 Text en Copyright© 2020 Ferrata Storti Foundation Material published in Haematologica is covered by copyright. All rights are reserved to the Ferrata Storti Foundation. Use of published material is allowed under the following terms and conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode. Copies of published material are allowed for personal or internal use. Sharing published material for non-commercial purposes is subject to the following conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode, sect. 3. Reproducing and sharing published material for commercial purposes is not allowed without permission in writing from the publisher.
spellingShingle Article
Perales, Miguel-Angel
Tomlinson, Benjamin
Zhang, Mei-Jie
St. Martin, Andrew
Beitinjaneh, Amer
Gibson, John
Hogan, William
Kekre, Natasha
Lazarus, Hillard
Marks, David
McGuirk, Joseph
Romee, Rizwan
Solh, Melhem
Wagner, John E.
Weisdorf, Daniel J.
de Lima, Marcos
Eapen, Mary
Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor?
title Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor?
title_full Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor?
title_fullStr Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor?
title_full_unstemmed Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor?
title_short Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor?
title_sort alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young hla-matched unrelated or haploidentical donor?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012481/
https://www.ncbi.nlm.nih.gov/pubmed/31101756
http://dx.doi.org/10.3324/haematol.2018.215202
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