The Institutional Review Boards of the Medical College of Wisconsin and the National Marrow Donor Program approved this study. We studied adults with acute myeloid leukemia (AML) after haploidentical (n = 192) and 8/8 HLA-matched unrelated donor (n = 1982) transplantation. Consistent with the main analyses, after myeloablative transplantation, there are no differences in survival, transplant-related mortality, or relapse by donor type and grade 2-4 acute GVHD, 3-4 acute GVHD, and chronic GVHD risks are higher after HLA-matched unrelated donor transplantation. (A) The cumulative incidence of relapse by donor type after myeloablative conditioning regimen, adjusted for disease risk index. 0000248881 00000 n Copyright ©2020 by American Society of Hematology, Document 1. Pr Okamoto presented a Retrospective Comparison of URD versus related haplo HSCT in Japan. Less than two months after the 1st and enormously successful European Symposium on CAR-T Cells, co-organized in Paris by the EBMT and the EHA, the 45th Annual Meeting of the EBMT held in Frankfurt was again a “hot spot” for those interested in the development of this new category of medicinal products, and more broadly of immune effector cell therapies.
The authors thank the bone marrow transplant coordinator's office, the physicians and nurses, and members of the bone marrow transplant service for providing outstanding care. In the reduced intensity setting, recipients of haploidentical transplants (n = 74) received BM grafts and tacrolimus with mycophenolate and posttransplant cyclophosphamide for GVHD prophylaxis. All rights reserved, Plenary and Special Sessions at EBMT 2019. Among recipients of haploidentical transplants, the remaining 14 deaths were attributed to the following: graft failure (n = 4, 7%), GVHD (n = 4, 7%), infection (n = 3, 5%), organ failure (n = 1, 2%), and not reported (n = 2, 4%). 0000248620 00000 n Summary of the Third Annual Blood and Marrow Transplant Clinical Trials Network Myeloma Intergroup Workshop on Minimal Residual Disease and Immune Profiling. 0000255664 00000 n Correspondence and reprint requests: Firoozeh Sahebi, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, 1500 Duarte Road, Duarte, CA 91010 . Colleagues from outside Europe with experience in this field and wishing to share their experience in Madrid are welcome and should contact the EGC. The remaining 8 deaths after haploidentical transplantation were attributed to: GVHD (n = 4, 8%), infection (n = 3, 6%), and graft failure (n = 1, 3%). Report of a workshop convened by the center for international blood and marrow transplant research. Although we were not able to identify a center effect, it remains to be seen whether the results observed in the current analyses will hold true if these transplants are performed more widely. 0000247475 00000 n In contrast, a large Center for International Blood and Marrow Transplant Research (CIBMTR) analysis by Bashey et al.
Haploidentical transplantation using T cell replete peripheral blood stem cells and myeloablative conditioning in patients with high-risk hematologic malignancies who lack conventional donors is well tolerated and produces excellent relapse-free survival: results of a prospective phase II trial. 0000114006 00000 n Last but not least, Matthew Porteus gave us insight into the future of gene editing. Acute and chronic GVHD were substantially lower after haploidentical transplantation. Castagna L, Mussetti A, Devillier R, Dominietto A, Marcatti M, Milone G, Maura F, de Philippis C, Bruno B, Furst S, Blaise D, Corradini P, Montefusco V. Biol Blood Marrow Transplant. There is currently no member login for the site. Haploidentical transplantations were performed at 19 transplant centers compared with the over 80 centers that performed HLA-matched unrelated donor transplantations. OS at 24 months was 69% (95% CI, 51% to 87%) for patients who received a BM graft and PT-Cy, compared with 38% (95% CI, 19% to 58%) for those who received a PB graft and PT-Cy (Supplementary Figure S5), indicating that the difference in OS by stem cell source may be independent of the use of PT-Cy. Effect of PT-Cy on a) OS, b) PFS, c) relapse, and d) NRM.
A recent retrospective comparison of BM and PB as the graft source in haploidentical allo-HCT recipients with various hematologic malignancies and receiving PT-Cy reported no significant differences in nonrelapse mortality risk, but a greater relapse risk with the use of BM [. Patients with a diagnosis of MM who underwent haploidentical allo-HCT in EBMT and CIBMTR centers were selected.
Among patients receiving myeloablative regimens, 3-year probabilities of overall survival were 45% (95% CI, 36-54) and 50% (95% CI, 47-53) after haploidentical and matched unrelated donor transplants (P = .38). 0000250955 00000 n
Reduced-intensity conditioning using fludarabine, melphalan and thiotepa for adult patients undergoing haploidentical SCT.
C8��� �C.C �#�5C�(�2�n���Tv2�f��������I��x+S/c��rF3�,G/2230l�4 B} ԃ�H" 1]0i5��0�c�� It explored the development of haploidentical transplantation (HAPLO) in China, Japan, Lebanon, India and Argentina.
0000252733 00000 n
However, any advantage derived from lower mortality risks with the very low intensity regimen for haploidentical transplantation was negated by higher relapse risks in this group. 0000251927 00000 n Nineteen patients then went to HAPLO.
The day 30 incidence of neutrophil recovery after haploidentical and HLA-matched unrelated donor myeloablative transplantation were 90% (95% CI, 84-94) and 97% (95% CI, 96-98), respectively; P = .02. 0000255390 00000 n Another issue was the prevalence of infectious diseases which made infection post transplantation an important post-transplant complication, with Acinetobacter, pseudomonas species, carbapenem resistance as well as fungal infection as major issues. There were no differences in 3-year rates of chronic GVHD after haploidentical and unrelated donor transplantation with myeloablative regimens (30% [95% CI, 21-39]; n = 85 vs 36% [95% CI, 30-43]; n = 231) or with reduced intensity regimens (34% [95% CI, 24-44]; n = 77 vs 30% [95% CI, 20-41]; n = 80). P values are two-sided and analyses were performed with SAS version 9.3 (Cary, NC).
TBF (Thiotepa, Busulfan, Fludarabin) was the preferred conditioning regimen. Fourth, haploidentical transplants were performed at 19 transplant centers, whereas unrelated donor transplants were performed at several more centers representing clinical practice across small-, mid-, and large-sized transplant centers. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis. Mobilized peripheral blood stem cells versus unstimulated bone marrow as a graft source for T-cell-replete haploidentical donor transplantation using post-transplant cyclophosphamide. The incidence of bacterial (44%), fungal (24%) and viral (53%) infections were high. 0000251279 00000 n Among recipients of myeloablative regimens, nonrelapse mortality risks were not different after haploidentical compared with HLA-matched unrelated donor transplantation (Figure 1A; Tables 3 and 4). USA.gov. Transplant conditioning regimen included TBI (200 cGy), cyclophosphamide, and fludarabine. 0000249235 00000 n Similar transplantation outcomes for acute myeloid leukemia and myelodysplastic syndrome patients with haploidentical versus 10/10 human leukocyte antigen-matched unrelated and related donors.
0000230831 00000 n Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Interval between diagnosis and transplant was not associated with relapse (HR, 0.85; 95% CI, 0.68-1.06; P = .14) or nonrelapse mortality (HR, 0.84; 95% CI, 0.53-1.34; P = .46). In vivo T-cell depletion with anti-thymocyte globulin (ATG) was not employed for haploidentical transplants. The intensity of the conditioning regimen (myeloablative conditioning versus reduced-intensity/nonmyeloablative conditioning) was not associated with significant differences in OS, PFS, NRM, or relapse rate (Supplementary Figure S3). Benchmarking of survival outcomes has been developed as an integral part of Project 2020, alongside the MACRO registry. 0000254769 00000 n We conducted a retrospective analysis to examine the outcome of patients with MM who underwent haploidentical allo-HCT using the EBMT and Center for International Blood and Marrow Transplant Research (CIBMTR) databases. The Indian stem cell transplant registry presently contains data on 14534 patients transplanted during the period from 1983 to2017. Neutrophil recovery was defined as achieving absolute neutrophil count ≥500/µL for 3 consecutive days and platelet recovery defined as achieving platelet counts ≥20 000/µL for at least 7 days, unsupported by transfusion. Outcomes of salvage autologous versus allogeneic hematopoietic cell transplantation for relapsed multiple myeloma after initial autologous hematopoietic cell transplantation. GVHD prophylaxis included tacrolimus or cyclosporine with methotrexate for 49%, tacrolimus or cyclosporine with mycophenolate for 43%, and tacrolimus or cyclosporine with sirolimus for 8% of patients.
0000033046 00000 n Published by Elsevier Inc. In contrast, the stem cell source was linked with a strong difference in OS at 2 years favoring the of use of BM over PB (72% [95% CI, 55% to 89%] versus 31% [95% CI, 17% to 46%]; The use of PT-Cy was associated with improved OS, with a 2-year OS of 54% (95% CI, 41% to 68%) vs 25% (95% CI, 1% to 48%) using no PT-Cy (. Copyright © 2020 Elsevier Inc. except certain content provided by third parties. |
0000112812 00000 n This work was presented in part at the 44th annual meeting of the European Society for Blood and Marrow Transplantation, Lisbon, Portugal, March 18-21, 2018.
Relapse was defined as morphologic, cytogenetic, or molecular leukemia recurrence. 0000003875 00000 n Table 1 shows the characteristics of patients and their disease for myeloablative regimens.
Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Outcomes of Haploidentical Transplantation in Patients with Relapsed Multiple Myeloma: An EBMT/CIBMTR Report. Comparable overall survival after haploidentical compared with matched unrelated donor transplant for AML. After reduced intensity conditioning transplantation, consistent with the main analyses, there are no differences in survival, relapse risks are higher after haploidentical transplantation and grade 3-4 acute GVHD, and chronic GVHD risks are higher after HLA-matched unrelated donor transplantation. Outcomes were analyzed only for patients with complete relapse information (n = 93).
Supplemental tables (PDF, 101 KB), https://doi.org/10.1182/blood-2015-04-639831. Since 2015, 66 HAPLO were done in 64 patients, which include 21 transplants in 2018. Epub 2020 Apr 10. Giralt S, Costa LJ, Maloney D, Krishnan A, Fei M, Antin JH, Brunstein C, Geller N, Goodman S, Hari P, Logan B, Lowsky R, Qazilbash MH, Sahebi F, Somlo G, Rowley S, Vogl DT, Vesole DH, Pasquini M, Stadtmauer E. Biol Blood Marrow Transplant.
0000251603 00000 n Tandem Autologous-Autologous versus Autologous-Allogeneic Hematopoietic Stem Cell Transplant for Patients with Multiple Myeloma: Long-Term Follow-Up Results from the Blood and Marrow Transplant Clinical Trials Network 0102 Trial.
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