Original Article | Published:

Acute Leukemias

A survey on unmanipulated haploidentical hematopoietic stem cell transplantation in adults with acute leukemia

Leukemia volume 29, pages 10691075 (2015) | Download Citation

Abstract

The use of unmanipulated graft is increasingly adopted in the setting of allogeneic hematopoietic stem cell transplantation from haploidentical family donors (haplo-SCT) in acute leukemia (AL). We analyzed the outcome of 229 adult patients with de novo AL, who received an unmanipulated haploidentical transplant as their first allo-SCT between 2007 and 2011. Median follow-up was 30 months. Disease status at transplant was: first complete remission (CR1) for 77, second CR (CR2) for 56, and advanced for 96 patients. One hundred and seventy-one patients received in vivo T-cell depletion by monoclonal antibodies (75%). The 60-day cumulative incidence (CI) of engraftment was 93±2%. The 100-day CI of acute graft-versus-host disease (GvHD) was 32±3% for grade II–IV, 12±3% for grade III–IV. The 3-year CI of chronic GvHD was 34±3%. The 3-year CI of non-relapse mortality was 31±4% with in vivo T-cell depletion and 17±5% without. At 3 years, for patients transplanted in CR1, CR2 or advanced disease leukemia-free survival was 44±6, 42±7 and 12±3%, overall survival was 55±6, 51±7 and 14±4% and CI of relapse was 32±6, 24±6 and 61±5%, respectively. These data suggest that unmanipulated haplo-SCT is a valid treatment option for adult AL patients in complete remission lacking a matched donor.

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Acknowledgements

We thank all the allogeneic transplantation centers of the EBMT group for reporting the data included in this analysis to this registry. A list of the participating EBMT centers appears in the Appendix.

Author Contributions

SP designed research, collected and checked the data, contacted transplantation centers, analyzed data and wrote the paper; ML designed research, analyzed data and wrote the paper; FC designed research and wrote the paper; AB and JT provided data and wrote the paper; N-CG wrote the paper; HH SS, YK, WD, BD, EG and WA provided data; AN and MM wrote the paper.

Author information

Affiliations

  1. Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy

    • S Piemontese
    •  & F Ciceri
  2. EBMT Paris Office, Hosital Saint Antoine, Paris, France

    • S Piemontese
    • , F Ciceri
    • , M Labopin
    • , N-C Gorin
    • , A Nagler
    •  & M Mohty
  3. AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France

    • M Labopin
    • , N-C Gorin
    •  & M Mohty
  4. Sorbonne Niversité, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France

    • M Labopin
    • , N-C Gorin
    •  & M Mohty
  5. INSERM, MR_S 938, CDR Saint-Antoine, Paris, France

    • M Labopin
    • , N-C Gorin
    •  & M Mohty
  6. Division of Hematology II, IRCCS, San Martino University Hospital—IST, Genoa, Italy

    • A Bacigalupo
  7. Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    • H Huang
  8. Department of Hematology, Ospedale Civile, Pescara, Italy

    • S Santarone
  9. Hematopoietic Stem Cell Transplantation Unit, Medical Park Hospital, Antalya, Turkey

    • Y Koc
  10. The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou, China

    • D Wu
  11. Department of Bone Marrow Transplantation, University Hospital, Essen, Germany

    • D Beelen
  12. University Hospital of Munich-Klinikum Grosshadern (LMU), Department of Internal Medicine III, Hematopoietic Cell Transplantation, Munich, Germany

    • J Tischer
  13. Medizinische Klinik und Poliklinik I, Universitaetsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany

    • G Ehninger
  14. Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy

    • W Arcese
  15. Chaim Sheba Medical Center, Tel-Hashomer, Israel

    • A Nagler

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to S Piemontese.

Appendices

Appendix

EBMT participating centers: Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan (61 patients); Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy (30 patients); Division of Hematology II, IRCCS, San Martino University Hospital—IST, Genoa, Italy (21 patients); The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (17 patients); Department of Hematology, Ospedale Civile, Pescara, Italy (16 patients); Hematopoietic Stem Cell Transplantation Unit, MedicalPark Hospital, Antalya, Turkey (13 patients); First Affiliated Hospital of Soochow University, Suzhou, China (13 patients); Department of Bone Marrow Transplantation, University Hospital, Essen, Germany (8 patients); University Hospital of Munich-Klinikum Grosshadern (LMU), Department of Internal Medicine III, Hematopoietic Cell Transplantation, Munich, Germany (6 patients); Medizinische Klinik und Poliklinik I, Universitaetsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany (6 patients); Azienda Ospedaliera, Reggio Calabria, Italy (5 patients); University Hospital Gasthuisberg, Leuven, Belgium (4 patients); Azienda Ospedali Riuniti di Ancona, Ancona-Torrete, Italy (4 patients); University Hospital, Basel, Switzerland (3 patients); University Hospital, Udine, Italy (3 patients); Gazi Universitesi Tip Fakültesi, Ankara, Turkey (2 patients); University Med. Center, Ljubljana, Slovenia (2 patients); Heilig Hartziekenhuis, Roeselare, Belgium (2 patients); Tel-Aviv University, Tel-Hashomer, Israel (2 patients); Hospital Guglielmo da Saliceto, Piacenza, Italy (1 patient); Universität Tübingen, Tübingen, Germany (1 patient); Unité de transplantation et de thérapie cellulaire, Marseille, France (1 patient); Ospedale S. Camillo-Forlanini, Rome, Italy (1 patient); Centre For Clinical Haematology, Birmingham, United Kingdom (1 patient); King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (1 patient); Helsinki University Central Hospital, Helsinki, Finland (1 patient); University Hospital Eppendorf, Hamburg, Germany (1 patient); Shariati Hospital,Teheran, Iran (1 patient); Umea University Hospital, Umeå, Sweden (1 patient); and University of Freiburg, Freiburg, Germany (1 patient).

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DOI

https://doi.org/10.1038/leu.2014.336

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