Outcomes of primary graft failure in acute myeloid leukemia patients following unrelated transplantation with post-transplant cyclophosphamide: a study from the ALWP/EBMT
We assessed pGF in 2497 AML patients undergoing HSCT from 8-10/10 HLA-matched UD with PTCy. pGF was defined as failure to achieve an ANC ≥ 0.5 × 10<sup>9</sup>/L by day +30 after HSCT. The day +30 cumulative incidence of ANC was 92.6% (95%CI: 91.5-93.6), and the incidence of death without ANC recovery was 1.8% (95% CI: 1.3%-2.3%), corresponding to 141 (5.6%) patients not achieving an ANC ≥ 0.5 × 10<sup>9</sup>/L by day +30. PB was the graft source in 89.4% of the patients, and 56% received reduced-intensity conditioning. 21 patients underwent a second HSCT (15 in the absence of ANC recovery and 6 after ANC recovery). 1-y NRM and RI post-pGF were 22.1% and 22.4%, respectively. 1-y LFS and OS post-pGF were 59% and 55.5%, respectively. ANC recovery evaluated as a time-dependent covariate, KPS ≥ 90, and being in CR at the time of HSCT were associated with improved OS. In conclusion, the incidence of pGF post-unrelated HSCT with PTCy was 5.6%. Of the patients who failed to engraft by day +30, 70.9% did so by day +60. A second transplant can save some of the patients with pGF.
Authors
- Е. Н. Паровичникова (ORCID: https://orcid.org/0000-0001-6177-3566)
- Peter A. von dem Borne (ORCID: https://orcid.org/0000-0002-7470-7346)
- Mohamad Mohty (ORCID: https://orcid.org/0000-0002-7264-808X)
- Didier Blaise (ORCID: https://orcid.org/0000-0002-5684-9447)
- Rodrigo Martino (ORCID: https://orcid.org/0000-0001-5143-4042)
- Fabio Ciceri (ORCID: https://orcid.org/0000-0003-0873-0123)
- Alexander Kulagin (ORCID: https://orcid.org/0000-0002-9589-4136)
- Jurjen Versluis (ORCID: https://orcid.org/0000-0003-2372-1663)
- Ali Bazarbachi (ORCID: https://orcid.org/0000-0002-7171-4997)
- Jaime Sanz (ORCID: https://orcid.org/0000-0001-6934-4619)
- Maija Itälä‐Remes (ORCID: https://orcid.org/0000-0001-5844-1632)
- Mieke W.H. Roeven
- Arnon Nagler (ORCID: https://orcid.org/0000-0002-0763-1265)
- Jacques‐Emmanuel Galimard (ORCID: https://orcid.org/0000-0001-9102-4427)
- Simona Sica (ORCID: https://orcid.org/0000-0003-2426-3465)
- Sarah Lindner (ORCID: https://orcid.org/0000-0002-9985-1205)
- Goda Choi (ORCID: https://orcid.org/0000-0003-2348-5947)
Institutions
- Università Cattolica del Sacro Cuore (IT)
- University Medical Center Groningen (NL)
- Radboud University Nijmegen (NL)
- Inserm (FR)
- First Pavlov State Medical University of St. Petersburg (RU)
- Sheba Medical Center (IL)
- Leiden University Medical Center (NL)
- Hospital de Sant Pau (ES)
- Turku University Hospital (FI)
- Radboud University Medical Center (NL)
- Hospital Universitari i Politècnic La Fe (ES)
- Humboldt-Universität zu Berlin (DE)
- Sorbonne Université (FR)
- National Medical Research Center for Hematology (RU)
- American University of Beirut Medical Center (LB)
- IRCCS Ospedale San Raffaele (IT)
- Centre de Recherche Saint-Antoine (FR)
- Centre de Recherche en Cancérologie de Marseille (FR)
- Erasmus MC Cancer Institute (NL)
- Freie Universität Berlin (DE)
- Charité - Universitätsmedizin Berlin (DE)
Publication Details
- Journal
- Bone Marrow Transplantation
- Published
- 2025-10-18
- DOI
- https://doi.org/10.1038/s41409-025-02726-8
- Primary Topic
- Hematopoietic Stem Cell Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Tel Aviv University