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Refined graft-versus-host disease/relapse-free survival in transplant from HLA-identical related or unrelated donors in acute myeloid leukemia

Bone Marrow Transplantation volume 53, pages 1295–1303 (2018)Cite this article

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Abstract

Refined graft-versus-host disease (GVHD)/relapse-free survival (GRFS) considers main outcomes of allogeneic stem cell transplant (HSCT), estimating long-term survival without significant morbidity as a surrogate of HSCT success. We compared GRFS in 5059 adults with acute myeloid leukemia (AML), undergoing HSCT in first complete remission from 2000 to 2015 either from a matched sibling (MSD, n = 3731) or unrelated donor (MUD, n = 1328). Median age was 49 (range: 18–76) years. Median follow-up was 32 and 60 months in MSD and MUD, respectively (p < 0.01). Compared to MSD, at 4 years, MUD recipients had lower GRFS, with higher NRM, grade III–IV acute GVHD, and extensive chronic GVHD (HR: 1.42, p < 0.01). We also performed a risk factor analyses, showing unfavorable cytogenetics (HR: 1.42, p < 0.01) and peripheral blood as stem cell source (HR: 1.22, p < 0.01) associated to lower GRFS, while this was higher with in vivo T-cell depletion (TCD, HR: 0.73, p < 0.01) and shorter time from diagnosis to HSCT (HR 0.96, p < 0.01). Different factors, modifiable or not, such as donor type, stem cell source, disease biology, and in vivo TCD, impact on GRFS and this may guide in the future transplant choices to improve morbidity and long-term quality of life.

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Acknowledgements

We thank Emmanuelle Polge from the office of the ALWP of EBMT.

Author contributions

GB, AR, AN designed the study. ML performed the statistical analysis. GB wrote the manuscript. AR, MM, and AN revised the manuscript and all the authors reviewed its final version. LV, DB, GS, RT, JJC, AG, AH, DW, IY-A, JM, PC were the principal investigators of the highest recruiting Centers of the study.

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Authors and Affiliations

  1. Hematology Department, Hôpital Saint Antoine, Service d’Hématologie et Thérapie Cellulaire, Paris, France

    Giorgia Battipaglia, Annalisa Ruggeri, Myriam Labopin & Mohamad Mohty

  2. Department of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children’s Hospital, Piazza S Onofrio, 4, Roma 00165, Italy

    Annalisa Ruggeri

  3. Hematology Department, Federico II University, Naples, Italy

    Giorgia Battipaglia

  4. Hospital Saint-Antoine, Paris University UPMC, INSERM U938, Paris, France

    Myriam Labopin & Mohamad Mohty

  5. Acute Leukemia Working Party of EBMT, Paris, France

    Myriam Labopin, Mohamad Mohty & Arnon Nagler

  6. Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Center, Helsinki, Finland

    Liisa Volin

  7. Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  8. Department of Hematology—BMT, Hopital St. Louis, Paris, France

    Gerard Socié

  9. CHU Bordeaux Hôpital Haut-Leveque, Pessac, France

    Reza Tabrizi

  10. Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands

    Jan J. Cornelissen

  11. Hematology-Oncology and BMT Research, Shariati Hospital, Teheran, Iran

    Ardeshir Ghavamzadeh

  12. Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France

    Anne Huynh

  13. Department of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China

    Depei Wu

  14. CHU de Lille, LIRIC, University of Lille2, INSERM U995, Lille, France

    Ibrahim Yakoub-Agha

  15. Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium

    Johan Maertens

  16. Department D’Hematologie, CHU Nantes, Nantes, France

    Patrice Chevallier

  17. Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Arnon Nagler

Authors
  1. Giorgia Battipaglia
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  16. Arnon Nagler
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Correspondence to Giorgia Battipaglia.

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Battipaglia, G., Ruggeri, A., Labopin, M. et al. Refined graft-versus-host disease/relapse-free survival in transplant from HLA-identical related or unrelated donors in acute myeloid leukemia. Bone Marrow Transplant 53, 1295–1303 (2018). https://doi.org/10.1038/s41409-018-0169-6

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  • DOI: https://doi.org/10.1038/s41409-018-0169-6

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