A survey on unmanipulated haploidentical hematopoietic stem cell transplantation in adults with acute leukemia

作者：Piemontese, S.^*; Ciceri, F.; Labopin, M.; Bacigalupo, A.; Huang, H.; Santarone, S.; Gorin, N-C; Koc, Y.; Wu, D.; Beelen, D.; Tischer, J.; Ehninger, G.; Arcese, W.; Nagler, A.; Mohty, M.

来源：Leukemia, 2015, 29(5): 1069-1075.

DOI：10.1038/leu.2014.336

• BONE-MARROW-TRANSPLANTATION
• RISK ACUTE-LEUKEMIA
• POSTTRANSPLANTATION CYCLOPHOSPHAMIDE
• HEMATOLOGIC MALIGNANCIES
• PERIPHERAL-BLOOD
• ACUTE GVHD
• DONOR
• OUTCOMES
• DEPLETION
• RECOMMENDATIONS

The use of unmanipulated graft is increasingly adopted in the setting of allogeneic hematopoietic stem cell transplantation from haploidentical family donors (haplo-SCT) in acute leukemia (AL). We analyzed the outcome of 229 adult patients with de novo AL, who received an unmanipulated haploidentical transplant as their first allo-SCT between 2007 and 2011. Median follow-up was 30 months. Disease status at transplant was: first complete remission (CR1) for 77, second CR (CR2) for 56, and advanced for 96 patients. One hundred and seventy-one patients received in vivo T-cell depletion by monoclonal antibodies (75%). The 60-day cumulative incidence (CI) of engraftment was 93 +/- 2%. The 100-day CI of acute graft-versus-host disease (GvHD) was 32 +/- 3% for grade II-IV, 12 +/- 3% for grade III-IV. The 3-year CI of chronic GvHD was 34 +/- 3%. The 3-year CI of non-relapse mortality was 31 +/- 4% with in vivo T-cell depletion and 17 +/- 5% without. At 3 years, for patients transplanted in CR1, CR2 or advanced disease leukemia-free survival was 44 +/- 6, 42 +/- 7 and 12 +/- 3%, overall survival was 55 +/- 6, 51 +/- 7 and 14 +/- 4% and CI of relapse was 32 +/- 6, 24 +/- 6 and 61 +/- 5%, respectively. These data suggest that unmanipulated haplo-SCT is a valid treatment option for adult AL patients in complete remission lacking a matched donor.

• 出版日期2015-5
• 单位苏州大学; 浙江大学