| Literature DB >> 26670632 |
Abraham S Kanate1, Alberto Mussetti2, Mohamed A Kharfan-Dabaja3, Kwang W Ahn4, Alyssa DiGilio5, Amer Beitinjaneh6, Saurabh Chhabra7, Timothy S Fenske8, Cesar Freytes9, Robert Peter Gale10, Siddhartha Ganguly11, Mark Hertzberg12, Evgeny Klyuchnikov13, Hillard M Lazarus14, Richard Olsson15, Miguel-Angel Perales16, Andrew Rezvani17, Marcie Riches18, Ayman Saad19, Shimon Slavin20, Sonali M Smith21, Anna Sureda22, Jean Yared23, Stefan Ciurea24, Philippe Armand25, Rachel Salit26, Javier Bolaños-Meade27, Mehdi Hamadani5.
Abstract
We evaluated 917 adult lymphoma patients who received haploidentical (n = 185) or HLA-matched unrelated donor (URD) transplantation either with (n = 241) or without antithymocyte globulin (ATG; n = 491) following reduced-intensity conditioning regimens. Haploidentical recipients received posttransplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis, whereas URD recipients received calcineurin inhibitor-based prophylaxis. Median follow-up of survivors was 3 years. The 100-day cumulative incidence of grade III-IV acute GVHD on univariate analysis was 8%, 12%, and 17% in the haploidentical, URD without ATG, and URD with ATG groups, respectively (P = .44). Corresponding 1-year rates of chronic GVHD on univariate analysis were 13%, 51%, and 33%, respectively (P < .001). On multivariate analysis, grade III-IV acute GVHD was higher in URD without ATG (P = .001), as well as URD with ATG (P = .01), relative to haploidentical transplants. Similarly, relative to haploidentical transplants, risk of chronic GVHD was higher in URD without ATG and URD with ATG (P < .0001). Cumulative incidence of relapse/progression at 3 years was 36%, 28%, and 36% in the haploidentical, URD without ATG, and URD with ATG groups, respectively (P = .07). Corresponding 3-year overall survival (OS) was 60%, 62%, and 50% in the 3 groups, respectively, with multivariate analysis showing no survival difference between URD without ATG (P = .21) or URD with ATG (P = .16), relative to haploidentical transplants. Multivariate analysis showed no difference between the 3 groups in terms of nonrelapse mortality (NRM), relapse/progression, and progression-free survival (PFS). These data suggest that reduced-intensity conditioning haploidentical transplantation with posttransplant cyclophosphamide does not compromise early survival outcomes compared with matched URD transplantation, and is associated with significantly reduced risk of chronic GVHD.Entities:
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Year: 2015 PMID： 26670632 PMCID： PMC4760094 DOI： 10.1182/blood-2015-09-671834
Source DB: PubMed Journal: Blood ISSN： 0006-4971 Impact factor: 22.113