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Myeloablative and reduced-intensity conditioning in HLA-haploidentical peripheral blood stem cell transplantation using post-transplant cyclophosphamide

Bone Marrow Transplantation volume 54, pages 432–441 (2019)Cite this article

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Abstract

We conducted two parallel prospective, multicenter, phase II studies to evaluate the safety and efficacy of HLA-haploidentical peripheral blood stem cell transplantation using post-transplant cyclophosphamide (PTCy-haploPBSCT) following myeloablative conditioning (MAC, n = 50) and reduced-intensity conditioning (RIC, n = 77). Event-free survival (EFS) at 1-year as for primary endpoint was 64% and 43% in the MAC and RIC groups, respectively. Neutrophil engraftment was achieved in 98% and 94% in the MAC and RIC groups, respectively. The incidences of grades II–IV and III–IV acute graft-versus-host disease (GVHD) were 18% and 8% in the MAC group, and 14% and 5% in the RIC group, respectively. Those of all grade and moderate to severe chronic GVHD at 2-year were 36% and 20% in the MAC group, and 27% and 20% in the RIC group, respectively. Overall survival (OS), EFS, nonrelapse mortality, and relapse rate at 2-year were 68%, 54%, 10%, and 36% in the MAC group, and 44%, 35%, 20%, and 45% in the RIC group, respectively. Notably, 83% and 86% of patients who survived without relapse stopped immunosuppressant at 2-year in the MAC and RIC groups, respectively. Our results indicate that both MAC and RIC are valid options for PTCy-haploPBSCT for adults with hematological malignancies.

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Acknowledgements

This work was supported by the grant from Regional Medicine Research Foundation (Tochigi, Japan), North Japan Hematology Study Group (NJHSG), and Japan Agency for Medical Research and Development (AMED, JP17ek0510012).

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Authors and Affiliations

  1. Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan

    Junichi Sugita & Takanori Teshima

  2. Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yusuke Kagaya

  3. Hematology/Oncology, Kyushu University Hospital, Fukuoka, Japan

    Toshihiro Miyamoto & Koichi Akashi

  4. Stem Cell Transplantation, Niigata University Medical and Dental Hospital, Niigata, Japan

    Yasuhiko Shibasaki

  5. Hematology and Oncology, Kurume University School of Medicine, Kurume, Japan

    Koji Nagafuji

  6. Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    Shuichi Ota

  7. Hematology, Nagaoka Red Cross Hospital, Nagaoka, Japan

    Tatsuo Furukawa

  8. Hematology/Nephrology/Rheumatology, Akita University Hospital, Akita, Japan

    Miho Nara

  9. Hematology, Toranomon Hospital, Tokyo, Japan

    Shuichi Taniguchi

  10. Karatsu Higashimatsuura Medical Center, Karatsu, Japan

    Mine Harada

  11. Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan

    Keitaro Matsuo

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  1. Junichi Sugita
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Correspondence to Takanori Teshima.

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Sugita, J., Kagaya, Y., Miyamoto, T. et al. Myeloablative and reduced-intensity conditioning in HLA-haploidentical peripheral blood stem cell transplantation using post-transplant cyclophosphamide. Bone Marrow Transplant 54, 432–441 (2019). https://doi.org/10.1038/s41409-018-0279-1

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