RT Journal Article
SR Electronic
T1 PTCy-based haploidentical vs matched related or unrelated donor reduced-intensity conditioning transplant for DLBCL
JF Blood Advances
JO Blood Adv
FD American Society of Hematology
SP 360
OP 369
DO 10.1182/bloodadvances.2018027748
VO 3
IS 3
A1 Dreger, Peter
A1 Sureda, Anna
A1 Ahn, Kwang Woo
A1 Eapen, Mary
A1 Litovich, Carlos
A1 Finel, Herve
A1 Boumendil, Ariane
A1 Gopal, Ajay
A1 Herrera, Alex F.
A1 Schmid, Christoph
A1 Diez-Martin, José Luis
A1 Fuchs, Ephraim
A1 Bolaños-Meade, Javier
A1 Gooptu, Mahasweta
A1 Al Malki, Monzr M.
A1 Castagna, Luca
A1 Ciurea, Stefan O.
A1 Dominietto, Alida
A1 Blaise, Didier
A1 Ciceri, Fabio
A1 Tischer, Johanna
A1 Corradini, Paolo
A1 Montoto, Silvia
A1 Robinson, Stephen
A1 Gülbas, Zafer
A1 Hamadani, Mehdi
YR 2019
UL http://www.bloodadvances.org/content/3/3/360.abstract
AB PTCy-based haplo-HCT provides lower chronic GVHD rates compared with matched sibling or unrelated donor HCT in DLBCL.Three-year OS and PFS after haplo-HCT was 46% and 38%, respectively, in DLBCL.This study retrospectively compared long-term outcomes of nonmyeloablative/reduced intensity conditioning (NMC/RIC) allogeneic hematopoietic cell transplantation (allo-HCT) from a haploidentical family donor (haplo-HCT) using posttransplant cyclophosphamide (PTCy) with those of matched sibling donor (MSD) and matched unrelated donor (MUD) with or without T-cell depletion (TCD+/TCD−) in patients with relapsed diffuse large B-cell lymphoma (DLBCL). Adult patients with DLBCL who had undergone their first NMC/RIC allo-HCT between 2008 and 2015 were included. Recipients of haplo-HCT were limited to those receiving graft-versus-host disease (GVHD) prophylaxis with PTCy. GVHD prophylaxis in MSD was limited to calcineurin inhibitor (CNI)–based approaches without in vivo TCD, while MUD recipients received CNI-based prophylaxis with or without TCD. Outcome analyses for overall survival (OS) and progression-free survival (PFS), nonrelapse mortality (NRM), and disease relapse/progression were calculated. A total of 1438 patients (haplo, 132; MSD, 525; MUD TCD+, 403; and MUD TCD−, 378) were included. Patients with haplo donors were significantly older, had a better performance status and had more frequently received total body irradiation-based conditioning regimens and bone marrow grafts than MSD and MUD TCD+ or TCD−. 3-year OS, PFS, NRM and relapse/progression incidence after haplo-HCT was 46%, 38%, 22%, and 41%, respectively, and not significantly different from outcomes of matched donor transplants on multivariate analyses. Haplo-HCT was associated with a lower cumulative incidence of chronic GVHD compared with MSD, MUD TCD+/TCD−. NMC/RIC haplo-HCT with PTCy seems to be a valuable alternative for patients with DLBCL considered for allo-HCT but lacking a matched donor.