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Comparable survival using a CMV-matched or a mismatched donor for CMV+ patients undergoing T-replete haplo-HSCT with PT-Cy for acute leukemia: a study of behalf of the infectious diseases and acute leukemia working parties of the EBMT

Bone Marrow Transplantation volume 53, pages 422–430 (2018)Cite this article

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Abstract

The role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4–24.8) and 18.8% (95% CI: 13.8–25.5) in the CMV D+/R+ and D−/R+ pairs, respectively (p = 0.40). Similarly, 1-year OS was 55.1% (95% CI: 50.1–58.0) and 55.7% (95% CI: 48.0–62.8) in the same groups (p = 0.50). The other main outcomes were comparable. No difference in NRM nor OS was observed after stratification for the intensity of conditioning and multivariate anaysis confirmed the lack of significant association with NRM or OS. In conclusion, the choice of a CMV-seronegative donor did not impair early survival of CMV-seropositive patients with acute leukemia after a first, non T-cell depleted haploidentical HSCT and PT-Cy among this series of 983 consecutive patients. Future research may focus on the assessment of the hierarchy of all the donor variables.

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Fig. 1: Putative patient-donor relationship based on the difference in age between the patient and the respective donor
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Acknowledgements

We thank Mr Rodney Seddon for the review of the english style of the manuscript. All the participating centers not included in the co-authorship are detailed in the Appendix.

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Authors and Affiliations

  1. Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

    Simone Cesaro & Gloria Tridello

  2. ASST Bergamo Ovest, Treviglio, Italy

    Roberto Crocchiolo

  3. BMT Data Office, Leiden, The Netherlands

    Nina Knelange

  4. Ospedale San Martino, Genova, Italy

    Maria Teresa Van Lint

  5. Medical Park Hospitals, Antalya, Turkey

    Yener Koc

  6. Ospedale S.Raffaele s.r.l., Milano, Italy

    Fabio Ciceri

  7. Anadolu Medical Center Hospital, Kocaeli, Turkey

    Zafer Gülbas

  8. Klinikum Grosshadern, Munich, Germany

    Johanna Tischer

  9. First State Pavlov Medical University of St., Petersburg, Russia

    Boris Afanasyev

  10. A.O.U Citta della Salute e della Scienza, Turin, Italy

    Benedetto Bruno

  11. Istituto Clinico Humanitas, Milano, Italy

    Luca Castagna

  12. Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  13. Hospital Saint Antoine, Paris, France

    Mohamad Mohty

  14. Azienda Ospedaliera Bianchi-Melacrino-Morelli di Reggio Calabria, Reggio Calabria, Italy

    Giuseppe Irrera

  15. Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain

    J. L. Diez-Martin

  16. Ospedale S. Camillo, Rome, Italy

    Luca Pierelli

  17. Ospedale San Gerardo, Monza, Italy

    Pietro Pioltelli

  18. Florence Nightingale Sisli Hospital, Istanbul, Turkey

    Mutlu Arat

  19. U.O. Ematologia con Trapianto, Bari, Italy

    Mario Delia

  20. Ospedale Infantile Regina Margherita, Torino, Italy

    Franca Fagioli

  21. Universitaetsklinikum Dresden, Dresden, Germany

    Gerhard Ehninger

  22. King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

    Mahmoud Aljurf

  23. IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy

    Angelo Michele Carella

  24. Baskent University Hospital, Yuregir Adana, Turkey

    Hakan Ozdogu

  25. University of Genoa, Genoa, Italy

    Malgorzata Mikulska

  26. Karolinska University Hospital, Stockholm, Sweden

    Per Ljungman

  27. Chaim Sheba Medical Center, Tel-Hashomer, Israel and Acute Leukemia Working Party Paris Office, Hopital Saint-Antoine, Université Pierre & Marie Curie, Paris, France

    Arnon Nagler

  28. University Hospital Collegium Medicum UMK, Bydgoszcz, Poland

    Jan Styczynski

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Correspondence to Roberto Crocchiolo.

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R.C. was an employee of MolMed S.p.A. at the time of submission. The remaining authors declare that they have no competing interests.

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Cesaro, S., Crocchiolo, R., Tridello, G. et al. Comparable survival using a CMV-matched or a mismatched donor for CMV+ patients undergoing T-replete haplo-HSCT with PT-Cy for acute leukemia: a study of behalf of the infectious diseases and acute leukemia working parties of the EBMT. Bone Marrow Transplant 53, 422–430 (2018). https://doi.org/10.1038/s41409-017-0016-1

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