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Acute Leukemia

Comparison of outcomes at two institutions of patients with ALL receiving ex vivo T-cell-depleted or unmodified allografts

Bone Marrow Transplantation volume 50, pages 493–498 (2015)Cite this article

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Abstract

We compared outcomes of adult patients receiving T-cell-depleted (TCD) hematopoietic SCT (HCT) without additional GVHD prophylaxis at Memorial Sloan Kettering Cancer Center (MSKCC, N=52), with those of patients receiving conventional grafts at MD Anderson Cancer Center (MDACC, N=115) for ALL in CR1 or CR2. Patients received myeloablative conditioning. Thirty-nine patients received anti-thymocyte globulin at MSKCC and 29 at MDACC. Cumulative incidence of grades 2–4 acute (P=0.001, 17.3% vs 42.6% at 100 days) and chronic GVHD (P=0.006, 13.5% vs 33.4% at 3 years) were significantly lower in the TCD group. The non-relapse mortality at day 100, 1 and 3 years was 15.4, 25.0 and 35.9% in the TCD group and 9.6, 23.6 and 28.6% in the unmodified group (P=0.368). There was no difference in relapse (P=0.107, 21.3% vs 35.5% at 3 years), OS (P=0.854, 42.6% vs 43.0% at 3 years) or RFS (P=0.653, 42.8% vs 35.9% at 3 years). In an adjusted model, age >50, cytogenetics and CR status were associated with inferior RFS (hazard ratio (HR)=2.16, P=0.003, HR=1.77, P=0.022, HR=2.47, P<0.001), whereas graft type was NS (HR=0.90, P=0.635). OS and RFS rates are similar in patients undergoing TCD or conventional HCT, but TCD effectively reduces the rate of GVHD.

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Acknowledgements

This work was supported in part by PO1 CA23766 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. MDACC authors had no acknowledgements.

Author Contributions

M-AP and PK designed and performed research, analyzed the data, enrolled patients in the study and wrote the manuscript; GSH and AH performed research, analyzed the data and wrote the manuscript; JDG, EBP, AAJ, RJO, REC, SG enrolled patients in the study and wrote the manuscript GR, PDH and SMD analyzed the data and wrote the manuscript. All authors approved the final manuscript.

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Author notes

  1. G S Hobbs and A Hamdi: These authors contributed equally to this work.

  2. M-A Perales and P Kebriaei: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Medicine, Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA,

    G S Hobbs, J D Goldberg, E B Papadopoulos, A A Jakubowski, S Giralt & M-A Perales

  2. Weill Cornell Medical College, New York, NY, USA

    G S Hobbs, J D Goldberg, E B Papadopoulos, A A Jakubowski, R J O'Reilly, S Giralt & M-A Perales

  3. Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    A Hamdi, C Ledesma, G Rondon, R E Champlin & P Kebriaei

  4. Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    P D Hilden & S M Devlin

  5. National University Hospital, Singapore, Singapore

    M L Poon

  6. Department of Pediatrics, Pediatric Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    R J O'Reilly

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  1. G S Hobbs
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  4. J D Goldberg
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Correspondence to M-A Perales or P Kebriaei.

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REC and PK received research support from Otsuka. The remaining authors declare no conflict of interest.

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Hobbs, G., Hamdi, A., Hilden, P. et al. Comparison of outcomes at two institutions of patients with ALL receiving ex vivo T-cell-depleted or unmodified allografts. Bone Marrow Transplant 50, 493–498 (2015). https://doi.org/10.1038/bmt.2014.302

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