Higher survival following transplantation with a mismatched unrelated donor with posttransplant cyclophosphamide‐based graft‐versus‐host disease prophylaxis than with double unit umbilical cord blood in patients with acute myeloid leukemia in first c

The best donor option for acute myeloid leukemia (AML) patients lacking an HLA-matched donor has remained intensively debated. We herein report the results of a large retrospective registry study comparing hematopoietic cell transplantation (HCT) outcomes between double-unit umbilical cord blood transplantation (dCBT, n = 209) versus 9/10 HLA-matched unrelated donor (UD) with posttransplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis (UD 9/10, n = 270) in patients with AML in first complete remission (CR1). Inclusion criteria consisted of adult patient, AML in CR1 at transplantation, either peripheral blood stem cells (PBSC) from UD 9/10 with PTCy as GVHD prophylaxis or dCBT without PTCy, transplantation between 2013 and 2021, and no in vivo T-cell depletion. The 180-day cumulative incidence of grade II-IV acute GVHD was 29% in UD 9/10 versus 44% in dCBT recipients (p = .001). After adjustment for covariates, dCBT recipients had a higher non-relapse mortality (HR = 2.35, 95% CI: 1.23-4.48; p = .01), comparable relapse incidence (HR = 1.12, 95% CI: 0.67-1.86; p = .66), lower leukemia-free survival (HR = 1.5, 95% CI: 1.01-2.23; p = .047), and lower overall survival (HR = 1.66, 95% CI: 1.08-2.55; p = .02) compared with patients receiving UD 9/10 HCT. In summary, our results suggest that transplantation outcomes are better with UD 9/10 with PTCy-based GVHD prophylaxis than with dCBT for AML patients in CR1. These data might support the use of UD 9/10 with PTCy-based GVHD prophylaxis over dCBT in AML patients lacking an HLA-matched donor.

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Publication Details

Journal
American Journal of Hematology
Published
2024-08-31
DOI
https://doi.org/10.1002/ajh.27466
Citations
2
Primary Topic
Hematopoietic Stem Cell Transplantation
Type
article
Field-Weighted Citation Impact
0.91

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article

Higher survival following transplantation with a mismatched unrelated donor with posttransplant cyclophosphamide‐based graft‐versus‐host disease prophylaxis than with double unit umbilical cord blood in patients with acute myeloid leukemia in first c

Myriam Labopin, Frédéric Baron, Peter A. von dem Borne, Didier Blaise et al.
2 citations
American Journal of Hematology
Hematopoietic Stem Cell Transplantation
0.91
article

Higher survival following transplantation with a mismatched unrelated donor with posttransplant cyclophosphamide‐based graft‐versus‐host disease prophylaxis than with double unit umbilical cord blood in patients with acute myeloid leukemia in first c

Myriam Labopin, Frédéric Baron, Peter A. von dem Borne, Didier Blaise, Fabio Ciceri, Alexander Kulagin, Jurjen Versluis, Patrice Chevallier, Jaime Sanz, Jan Vydra, Claude‐Eric Bulabois, Rachel Protheroe, Jenny Byrne, Emma Nicholson, Annalisa Ruggeri, Édouard Forcade, Mohamad Mohty, Montserrat Rovira
article en
2 citations

Abstract

The best donor option for acute myeloid leukemia (AML) patients lacking an HLA-matched donor has remained intensively debated. We herein report the results of a large retrospective registry study comparing hematopoietic cell transplantation (HCT) outcomes between double-unit umbilical cord blood transplantation (dCBT, n = 209) versus 9/10 HLA-matched unrelated donor (UD) with posttransplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis (UD 9/10, n = 270) in patients with AML in first complete remission (CR1). Inclusion criteria consisted of adult patient, AML in CR1 at transplantation, either peripheral blood stem cells (PBSC) from UD 9/10 with PTCy as GVHD prophylaxis or dCBT without PTCy, transplantation between 2013 and 2021, and no in vivo T-cell depletion. The 180-day cumulative incidence of grade II-IV acute GVHD was 29% in UD 9/10 versus 44% in dCBT recipients (p = .001). After adjustment for covariates, dCBT recipients had a higher non-relapse mortality (HR = 2.35, 95% CI: 1.23-4.48; p = .01), comparable relapse incidence (HR = 1.12, 95% CI: 0.67-1.86; p = .66), lower leukemia-free survival (HR = 1.5, 95% CI: 1.01-2.23; p = .047), and lower overall survival (HR = 1.66, 95% CI: 1.08-2.55; p = .02) compared with patients receiving UD 9/10 HCT. In summary, our results suggest that transplantation outcomes are better with UD 9/10 with PTCy-based GVHD prophylaxis than with dCBT for AML patients in CR1. These data might support the use of UD 9/10 with PTCy-based GVHD prophylaxis over dCBT in AML patients lacking an HLA-matched donor.

American Journal of HematologyVol. 99(12)
University of Nottingham (GB), Vita-Salute San Raffaele University (IT), Inserm (FR), University of Liège (BE), First Pavlov State Medical University of St. Petersburg (RU), Leiden University Medical Center (NL), Centre Hospitalier Universitaire de Grenoble (FR), University Hospitals Bristol NHS Foundation Trust (GB), Hospital Universitari i Politècnic La Fe (ES), Centre Hospitalier Universitaire de Nantes (FR), Sorbonne Université (FR), Institute of Haematology and Blood Transfusion (CZ), Hôpital Saint-Antoine (FR), Hospital Clínic de Barcelona (ES), Royal Marsden Hospital (GB), IRCCS Ospedale San Raffaele (IT), Centre de Recherche Saint-Antoine (FR), Erasmus MC Cancer Institute (NL), Institut Paoli-Calmettes (FR), European Society for Blood and Marrow Transplantation (FR), University Hospitals Bristol and Weston NHS Foundation Trust (GB), Université Grenoble Alpes (FR)
Fonds De La Recherche Scientifique - FNRS
Openalex Percentile: Top 23%
Hematopoietic Stem Cell Transplantation
0.91
DOIOpen Access PDFOpenAlex
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