Title :

Related donor transplants: has posttransplantation cyclophosphamide nullified the detrimental effect of HLA mismatch?

Author(s) :

Robinson Tara, M [Auteur]
Fuchs Ephraim, J [Auteur]
Zhang, Mei-Jie [Auteur]
St Martin, Andrew [Auteur]
Labopin, Myriam [Auteur]
Keesler Daniel, A [Auteur]
Blaise, Didier [Auteur]
Bashey, Asad [Auteur]
Bourhis, Jean-Henri [Auteur]
Ciceri, Fabio [Auteur]
Ciurea Stefan, O [Auteur]
Devine Steven, M [Auteur]
Mohty, Mohamad [Auteur]
Mccurdy Shannon, R [Auteur]
Milpied, Noel [Auteur]
Mcniece Ian, K [Auteur]
Rocha, Vanderson [Auteur]
Romee, Rizwan [Auteur]
Socie, Gerard [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Soiffer Robert, J [Auteur]
Eapen, Mary [Auteur]
Nagler, Arnon [Auteur]

Journal title :

Blood advances

Abbreviated title :

Blood Adv.

Volume number :

2

Pages :

1180-1186

Publication date :

2018-06-12

ISSN :

2473-9537
2473-9537

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

We sought to identify whether posttransplantation cyclophosphamide (PT-Cy) reduces or eliminates the detrimental impact of HLA mismatching on outcomes of HLA-haploidentical related donor transplantation for acute leukemia. ...
Show more >We sought to identify whether posttransplantation cyclophosphamide (PT-Cy) reduces or eliminates the detrimental impact of HLA mismatching on outcomes of HLA-haploidentical related donor transplantation for acute leukemia. Data from 2143 donor-recipient pairs (n = 218 haploidentical sibling; n = 218 offspring; n = 1707 HLA-matched sibling) with acute myeloid or lymphoblastic leukemia were studied. All received a calcineurin inhibitor for graft-versus-host disease (GVHD) prophylaxis while high-dose PT-Cy was also given to recipients of haploidentical transplant. Patient age correlated with donor-recipient relationship: haploidentical siblings donated to patients aged 18 to 54 years whereas offspring donated to patients aged 55 to 76 years. Therefore, transplant outcomes were examined separately in the 2 patient age groups. In patients aged 18 to 54 years, there were no significant differences in outcomes except chronic GVHD, which was lower after haploidentical sibling compared to HLA-matched sibling transplant (hazard ratio [HR], 0.63; P < .001). In patients aged 55 to 76 years, despite lower chronic GVHD (HR, 0.42; P < .001), graft failure (14% vs 6%; P = .003), nonrelapse mortality (HR, 1.48; P = .02), and overall mortality (HR, 1.32; P = .003) were higher after transplant from offspring compared with an HLA-matched sibling. These data demonstrate a superior outcome in older recipients when using an HLA-matched sibling instead of offspring, although there were differences in transplant platforms (GVHD prophylaxis and graft type) between the 2 groups. Validation of these findings requires a prospective randomized trial wherein the transplant platforms can be closely matched.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:08:10Z