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Haplo-identical allografting with post-transplant cyclophosphamide in high-risk patients.
Brunello, Lucia; Passera, Roberto; Dellacasa, Chiara Maria; Giaccone, Luisa; Audisio, Ernesta; Ferrero, Dario; D'Ardia, Stefano; Allione, Bernardino; Aydin, Semra; Festuccia, Moreno; Lia, Giuseppe; Crisà, Elena; Maffini, Enrico; Butera, Sara; Busca, Alessandro; Bruno, Benedetto.
Afiliación
  • Brunello L; Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy.
  • Passera R; Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
  • Dellacasa CM; Division of Nuclear Medicine, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
  • Giaccone L; Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy.
  • Audisio E; Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy.
  • Ferrero D; Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
  • D'Ardia S; Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
  • Allione B; Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
  • Aydin S; Department of Oncology, Division of Hematology Univ., Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
  • Festuccia M; Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
  • Lia G; Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
  • Crisà E; Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Italy.
  • Maffini E; Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy.
  • Butera S; Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
  • Busca A; Department of Oncology, SSD Trapianto Allogenico, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Torino, Italy.
  • Bruno B; Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.
Ann Hematol ; 97(11): 2205-2215, 2018 Nov.
Article en En | MEDLINE | ID: mdl-29987350
Haplo-identical transplants (Haplo-Tx) are an important alternative for patients with hematological malignancies who lack a HLA-identical donor. Seventy-one T-replete Haplo-Tx were performed in 70 high-risk patients at our center; 22/70 (31%) patients with refractory/relapsed leukemia received sequential salvage therapy (SeqTh) with high-dose chemotherapy followed by Haplo-Tx during the chemotherapy-induced neutropenia. Graft-versus-host disease (GVHD) prophylaxis consisted of post-transplant cyclophosphamide (days + 3 and + 4) with tacrolimus and mycophenolic acid. After a median follow-up of 29.2 months, 3-year overall survival (OS) and event-free survival (EFS) were 43.8 and 40.2%, while 3-year cumulative incidences (CIs) of non-relapse mortality (NRM) and relapse (RI) were 27 and 33%. Day 100 and day 400 CI of grade III-IV acute and moderate-severe chronic GVHD were 11 and 15%. Three-year RI was significantly lower in patients in complete remission (CR) versus those not in CR at the time of transplant (21.5 vs. 48%, p = 0.009) and in patients who received PBSC as compared to BM (22 vs. 45%, p = 0.009). In patients treated with SeqTh, 3-year OS was 19%, while 3-year RI and NRM were 52 and 28% at a median follow-up of 50 months. Overall, Haplo-Tx was feasible in heavily pretreated high-risk patients without a suitable HLA-identical donor.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia / Sistema de Registros / Trasplante de Células Madre Hematopoyéticas / Neoplasias Hematológicas / Ciclofosfamida / Enfermedad Injerto contra Huésped Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia / Sistema de Registros / Trasplante de Células Madre Hematopoyéticas / Neoplasias Hematológicas / Ciclofosfamida / Enfermedad Injerto contra Huésped Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2018 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania