T-cell-replete haploidentical transplantation versus autologous stem cell transplantation in adult acute leukemia: a matched pair analysis

Adult patients with acute leukemia in need of a transplant but without a genoidentical donor are usually considered upfront for transplantation with stem cells from any other allogeneic source, rather than autologous stem cell transplantation. We used data from the European Society for Blood and Mar...

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Bibliographic Details
Published in:Haematologica (Roma) 2015-04, Vol.100 (4), p.558-564
Main Authors: Gorin, Norbert-Claude, Labopin, Myriam, Piemontese, Simona, Arcese, William, Santarone, Stella, Huang, He, Meloni, Giovanna, Ferrara, Felicetto, Beelen, Dietrich, Sanz, Miguel, Bacigalupo, Andrea, Ciceri, Fabio, Mailhol, Audrey, Nagler, Arnon, Mohty, Mohamad
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Adult
Aged
Female
Follow-Up Studies
Graft vs Host Disease - etiology
Graft vs Host Disease - prevention & control
Haplotypes
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic Stem Cell Transplantation - methods
Humans
Leukemia - diagnosis
Leukemia - mortality
Leukemia - therapy
Lymphocyte Depletion
Male
Matched-Pair Analysis
Middle Aged
Survival Analysis
Transplantation Conditioning
Transplantation, Autologous
Transplantation, Homologous
Treatment Outcome
Young Adult
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Summary:Adult patients with acute leukemia in need of a transplant but without a genoidentical donor are usually considered upfront for transplantation with stem cells from any other allogeneic source, rather than autologous stem cell transplantation. We used data from the European Society for Blood and Marrow Transplantation and performed a matched pair analysis on 188 T-cell-replete haploidentical and 356 autologous transplants done from January 2007 to December 2012, using age, diagnosis, disease status, cytogenetics, and interval from diagnosis to transplant as matching factors. "Haploidentical expert" centers were defined as having reported more than five haploidentical transplants for acute leukemia (median value for the study period). The median follow-up was 28 months. Multivariate analyses, including type of transplant categorized into three classes ("haploidentical regular", "haploidentical expert" and autologous), conditioning intensity (reduced intensity versus myeloablative conditioning) and the random effect taking into account associations related to matching, showed that non-relapse mortality was higher following haploidentical transplants in expert (HR: 4.7; P=0.00004) and regular (HR: 8.98; P
ISSN:0390-6078
1592-8721
DOI:10.3324/haematol.2014.111450