Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT
Availability of haploidentical donors has broadened utilization of allogeneic hematopoietic cell transplantation (allo-HCT). Peripheral blood stem cells (PBSC) are being used with increased frequency in haploidentical allo-HCT. We evaluated extent of HLA disparity (2–3/8 versus 4/8 HLA antigen misma...
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| Format: | Article |
| Language: | English |
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Wiley
2023-07-01
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| Series: | HemaSphere |
| Online Access: | http://journals.lww.com/10.1097/HS9.0000000000000920 |
| _version_ | 1797280329784885248 |
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| author | Mohamed A. Kharfan-Dabaja Myriam Labopin Ernesto Ayala Ali Bazarbachi Didier Blaise Jan Vydra Stefania Bramanti Maija Itälä-Remes Christoph Schmid Alessandro Busca Edouard Forcade Werner Rabitsch Marco Zecca Nicolaus Kröger Claude-Eric Bulabois Giovanni Grillo Alessandro Rambaldi Renato Fanin Francesco Zallio Nicola Di Renzo Yener Koc Yana Novis Andrew McDonald Concepcion Herrera Arroyo Jaime Sanz Arnon Nagler Fabio Ciceri Mohamad Mohty |
| author_facet | Mohamed A. Kharfan-Dabaja Myriam Labopin Ernesto Ayala Ali Bazarbachi Didier Blaise Jan Vydra Stefania Bramanti Maija Itälä-Remes Christoph Schmid Alessandro Busca Edouard Forcade Werner Rabitsch Marco Zecca Nicolaus Kröger Claude-Eric Bulabois Giovanni Grillo Alessandro Rambaldi Renato Fanin Francesco Zallio Nicola Di Renzo Yener Koc Yana Novis Andrew McDonald Concepcion Herrera Arroyo Jaime Sanz Arnon Nagler Fabio Ciceri Mohamad Mohty |
| author_sort | Mohamed A. Kharfan-Dabaja |
| collection | DOAJ |
| description | Availability of haploidentical donors has broadened utilization of allogeneic hematopoietic cell transplantation (allo-HCT). Peripheral blood stem cells (PBSC) are being used with increased frequency in haploidentical allo-HCT. We evaluated extent of HLA disparity (2–3/8 versus 4/8 HLA antigen mismatches) on post-allograft outcomes when using T-cell replete PBSC from haploidentical donors for acute myeloid leukemia in first complete remission. Primary objectives entailed assessing cumulative incidence of grade 2–4 acute graft-versus-host disease (GVHD) and chronic GVHD (any grade). A total of 645 patients received a haploidentical allo-HCT from a donor with either 2–3 of 8 HLA antigen mismatches (n = 180) or with 4 of 8 HLA antigen mismatches (n = 465). Presence of 2–3 of 8 versus 4 of 8 HLA mismatches did not affect the incidence of acute GVHD (grade 2–4) and chronic GVHD (any grade). Overall survival (OS), leukemia-free survival (LFS) relapse incidence (RI), nonrelapse mortality and the composite endpoint of GVHD-free relapse-free survival were also similar among the groups. Pertaining to HLA-B leader matching effect, our analysis did not discern any difference in aforementioned post-allograft outcomes for this variable. However, in univariate analysis, absence of an antigen mismatch in HLA-DPB1 showed a trend for better OS. Notwithstanding inherent limitations associated with registry data, our results did not show an advantage of selecting a haploidentical donor with 2–3 of 8 HLA antigen mismatches over one with 4 of 8 HLA antigen mismatches when using PBSC as the cell source. Adverse cytogenetics remains a major adverse determinant of inferior OS and LFS and a higher RI. Using reduced-intensity conditioning yielded worse OS and LFS. |
| first_indexed | 2024-03-07T16:38:36Z |
| format | Article |
| id | doaj.art-a86fb26892d24374b8fde8eaa22d0625 |
| institution | Directory Open Access Journal |
| issn | 2572-9241 |
| language | English |
| last_indexed | 2024-03-07T16:38:36Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | HemaSphere |
| spelling | doaj.art-a86fb26892d24374b8fde8eaa22d06252024-03-03T09:15:18ZengWileyHemaSphere2572-92412023-07-0177e92010.1097/HS9.0000000000000920202307000-00006Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMTMohamed A. Kharfan-Dabaja0Myriam Labopin1Ernesto Ayala2Ali Bazarbachi3Didier Blaise4Jan Vydra5Stefania Bramanti6Maija Itälä-Remes7Christoph Schmid8Alessandro Busca9Edouard Forcade10Werner Rabitsch11Marco Zecca12Nicolaus Kröger13Claude-Eric Bulabois14Giovanni Grillo15Alessandro Rambaldi16Renato Fanin17Francesco Zallio18Nicola Di Renzo19Yener Koc20Yana Novis21Andrew McDonald22Concepcion Herrera Arroyo23Jaime Sanz24Arnon Nagler25Fabio Ciceri26Mohamad Mohty271 Division of Hematology-Oncology and Blood and Marrow Transplantation and Cellular Therapy Program, Mayo Clinic, Jacksonville, FL, USA2 Department of Hematology, Hôpital Saint Antoine, Sorbonne University and INSERM UMRs 938, Paris, France1 Division of Hematology-Oncology and Blood and Marrow Transplantation and Cellular Therapy Program, Mayo Clinic, Jacksonville, FL, USA4 Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Lebanon5 Programme de Transplantation and Therapie Cellulaire, Department of Hematology, Management Sport Cancer (MSC) Lab, Aix Marseille University, Institut Paoli Calmettes, Marseille, France6 Institute of Hematology and Blood Transfusion, Prague, Czech Republic7 IRCCS Istituto Clinico Humanitas, Rozzano, Milano, Italy8 Turku University Hospital, TD7 (Stem Cell Transplant Unit), Turku, Finland9 Augsburg University Hospital and Medical Faculty, Augsburg, Germany10 S.S.C.V.D Trapianto di Cellule Staminali, A.O.U Citta della Salute e della Scienza di Torino, Italy11 Service d’Hématologie Clinique et Thérapie Cellulaire, CHU Bordeaux, France12 Medizinische Universitaet Wien, Klinik fuer Innere Medizin I Knochenmarktransplantation, Vienna, Austria13 Paediatric Haematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy14 University Hospital Eppendorf, Bone Marrow Transplantation Centre, Hamburg, Germany15 CHU Grenoble Alpes - Université Grenoble Alpes, Service d`Hématologie, France16 ASST Grande Ospedale Metropolitano Niguarda, Hematology Department, Milano, Italy17 Department of Oncology and Hematology, University of Milan and Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy18 Azienda Ospedaliero Universitaria di Udine, Division of Hematology, Italy19 H SS. Antonio e Biagio, Haematology Department, Alessandria, Italy20 Unita Operativa di Ematologia e Trapianto di cellule staminali, Lecce, Italy21 Medicana International Hospital Istanbul, Bone Marrow Transplant Unit, Istanbul, Turkey22 Hospital Sirio-Libanes, Hematology Bone Marrow Transplant Unit, Sao_Paulo, Brazil23 Alberts Cellular Therapy, Netcare Pretoria East Hospital, Pretoria, South Africa24 Reina Sofia University Hospital, IMIBIC, University of Cordoba, Spain25 Hematology Department, Hospital Universitari i Politècnic La Fe, Avinguda Fernando Abril Martorell, Valencia, Spain26 Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel27 Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy2 Department of Hematology, Hôpital Saint Antoine, Sorbonne University and INSERM UMRs 938, Paris, FranceAvailability of haploidentical donors has broadened utilization of allogeneic hematopoietic cell transplantation (allo-HCT). Peripheral blood stem cells (PBSC) are being used with increased frequency in haploidentical allo-HCT. We evaluated extent of HLA disparity (2–3/8 versus 4/8 HLA antigen mismatches) on post-allograft outcomes when using T-cell replete PBSC from haploidentical donors for acute myeloid leukemia in first complete remission. Primary objectives entailed assessing cumulative incidence of grade 2–4 acute graft-versus-host disease (GVHD) and chronic GVHD (any grade). A total of 645 patients received a haploidentical allo-HCT from a donor with either 2–3 of 8 HLA antigen mismatches (n = 180) or with 4 of 8 HLA antigen mismatches (n = 465). Presence of 2–3 of 8 versus 4 of 8 HLA mismatches did not affect the incidence of acute GVHD (grade 2–4) and chronic GVHD (any grade). Overall survival (OS), leukemia-free survival (LFS) relapse incidence (RI), nonrelapse mortality and the composite endpoint of GVHD-free relapse-free survival were also similar among the groups. Pertaining to HLA-B leader matching effect, our analysis did not discern any difference in aforementioned post-allograft outcomes for this variable. However, in univariate analysis, absence of an antigen mismatch in HLA-DPB1 showed a trend for better OS. Notwithstanding inherent limitations associated with registry data, our results did not show an advantage of selecting a haploidentical donor with 2–3 of 8 HLA antigen mismatches over one with 4 of 8 HLA antigen mismatches when using PBSC as the cell source. Adverse cytogenetics remains a major adverse determinant of inferior OS and LFS and a higher RI. Using reduced-intensity conditioning yielded worse OS and LFS.http://journals.lww.com/10.1097/HS9.0000000000000920 |
| spellingShingle | Mohamed A. Kharfan-Dabaja Myriam Labopin Ernesto Ayala Ali Bazarbachi Didier Blaise Jan Vydra Stefania Bramanti Maija Itälä-Remes Christoph Schmid Alessandro Busca Edouard Forcade Werner Rabitsch Marco Zecca Nicolaus Kröger Claude-Eric Bulabois Giovanni Grillo Alessandro Rambaldi Renato Fanin Francesco Zallio Nicola Di Renzo Yener Koc Yana Novis Andrew McDonald Concepcion Herrera Arroyo Jaime Sanz Arnon Nagler Fabio Ciceri Mohamad Mohty Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT HemaSphere |
| title | Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT |
| title_full | Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT |
| title_fullStr | Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT |
| title_full_unstemmed | Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT |
| title_short | Significance of Degree of HLA Disparity Using T-cell Replete Peripheral Blood Stem Cells From Haploidentical Donors With Posttransplantation Cyclophosphamide in AML in First Complete Hematologic Remission: A Study of the Acute Leukemia Working Party of the EBMT |
| title_sort | significance of degree of hla disparity using t cell replete peripheral blood stem cells from haploidentical donors with posttransplantation cyclophosphamide in aml in first complete hematologic remission a study of the acute leukemia working party of the ebmt |
| url | http://journals.lww.com/10.1097/HS9.0000000000000920 |
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