Comparison of Outcomes after Unrelated Double-Unit Cord Blood and Haploidentical Peripheral Blood Stem Cell Transplantation in Adults with Acute Myelogenous Leukemia: A Study on Behalf of Eurocord and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Annalisa Ruggeri*, Jacques Emmanuel Galimard, Myriam Labopin, Hanadi Rafii, Didier Blaise, Fabio Ciceri, Jose Luiz Diez-Martin, Jan Cornelissen, Patrice Chevallier, Fermin Sanchez-Guijo, Emma Nicholson, Luca Castagna, Edouard Forcade, Jürgen Kuball, Montserrat Rovira, Yener Koc, Jiri Pavlu, Zafar Gulbas, Jan Vydra, Frederic BaronJaime Sanz, Alexandros Spyridonidis, Bipin Savani, Eliane Gluckman, Arnon Nagler, Mohamad Mohty

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Unmanipulated haploidentical hematopoietic stem cell transplantation (HCT) with post-transplantation cyclophosphamide as graft-versus-host disease (GVHD) prophylaxis (haplo-PTCY) and unrelated double-unit umbilical cord blood transplantation (dUCBT) are feasible options for treating patients with high-risk acute myelogenous leukemia (AML). This study compared outcomes after dUCBT and haplo-HCT using peripheral blood stem cells (PBSCs) in adult patients with AML in complete remission (CR) who underwent transplantation in European Society for Blood and Marrow Transplantation (EBMT)-affiliated centers. In a population of adults with de novo AML in first or second CR, we compared outcomes after dUCBT (n = 165) and after haplo-PTCY PBSC (n = 544) performed between January 2013 and December 2018. Patients receiving in vivo antithymocyte globulin, Campath, or ex vivo T cell depletion were excluded. The median follow-up was 33 months for the haplo-PTCY arm and 52 months for the dUCBT arm. No statistically significant differences were observed between the 2 arms in the rates of grade II-IV acute graft-versus-host disease (GVHD) (hazard ratio [HR], 1.31; P =. 18), grade III-IV acute GVHD (HR, 1.17; P =. 56), chronic GVHD (HR,. 86; P =. 48), relapse (HR, 1.07; P =. 77), nonrelapse mortality (NRM) (HR,. 94; P =. 77), leukemia-free survival (LFS) (HR,. 99; P =. 95), or overall survival (OS) (HR,. 99; P =. 97). Favorable cytogenetic risk was the sole factor predictive of lower relapse incidence (RI). Younger age at transplantation was associated with lower NRM and higher LFS and OS. Both dUCBT and haplo-PTCY with PBSCs can be considered valid approaches for adult AML patients in CR. New strategies should be investigated in both settings to define the most appropriate conditioning regimen and potentially decrease RI and NRM through better immune reconstitution and optimal supportive care.

Original languageEnglish
Pages (from-to)710.e1-710.e10
JournalTransplantation and Cellular Therapy
Volume28
Issue number10
DOIs
Publication statusPublished - Oct 2022

Bibliographical note

Funding Information:
The authors thank Emmanuelle Polge and Chantal Kenzey for helping with data collection, as well as the principal investigators from the participating EBMT centers listed in the Appendix. Financial disclosure: No financial disclosures related with this study. Conflict of interest statement: There are no conflicts of interest to report. Authorship statement: A.R. E.G. A.N. M.M. designed the study; D.B. F.C. J.D.M. J.J.C. P.C. F.S.G. E.N. L.C. E.F. J.K. M.R. Y.K. J.P. Z.G. J.V. F.B. J.S. A.S. and B.P. provided cases for the study; J.E.G. and M.L. analyzed data and performed the statistical analysis; A.R. and H.R. wrote the manuscript; and all authors edited and approved the final manuscript for publication. Financial disclosure: See Acknowledgments on page 710.e7.

Publisher Copyright:
© 2022 The American Society for Transplantation and Cellular Therapy

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