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Non-T depleted haploidentical stem cell transplantation in AML patients achieving first complete remission after one versus two induction courses: a study from the ALWP/EBMT

Bone Marrow Transplantation volume 57, pages 572–578 (2022)Cite this article

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Abstract

There are no data indicating whether the number of induction courses needed to achieve first complete remission (CR1) is of prognostic significance in Haploidentical transplantation (HaploSCT). We compared transplantation outcomes of adults with AML that underwent HaploSCT in CR1, achieved following one or two induction courses. A total of 635 patients were included: 469 (74%) with 1 and 166 (26%) with two induction chemotherapy courses. A total of 429 (91.5%) and 151 (91%) patients had de novo AML and 40 (8.5%) and 15 (9%) had secondary AML (p = 0.84). Engraftment rates were 97.2 and 97.6%. Day 180 incidence of acute GVHD II-IV and III-IV was similar in both induction groups (31.1 and 34.8%, and 10 and 10.6 %), as was 2–4 year total and extensive chronic GVHD (33.7 and 36.5 %, and 12.2 and 12.1%), respectively. Two-year relapse incidence (RI) was higher while leukemia-free survival (LFS), overall survival (OS) and GVHD-free, relapse-free survival (GRFS) were inferior for patients achieving CR1 with 2 vs 1 course and were 29.1% vs 15.1%, 88 (p = 0.001), 56.2% vs 66.9% (p = 0.03), 58.8% vs 72.2% (p = 0.044) and 44% vs 55.6% (p = 0.013), respectively. Non-relapse mortality (NRM) did not differ, 18% vs 14.6% 90 (p = 0.25). These results were confirmed by multivariate analysis.

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Fig. 1: Haploidentical allogeneic  stem cell transplantation outcome in AML patients achieving first complete remission after one versus two induction courses.

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Acknowledgements

We thank all the European Society for Blood and Marrow Transplantation (EBMT) centers and national registries for contributing patients to this study (Supplementary appendix material). We also thank the data managers for their excellent work.

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Authors and Affiliations

  1. Division of Hematology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel

    Arnon Nagler

  2. ALWP of the EBMT Paris office, Paris, France

    Arnon Nagler & Myriam Labopin

  3. Sorbonne University, Department of Haematology, Saint Antoine Hospital; INSERM UMR 938, Paris, France

    Myriam Labopin & Mohamad Mohty

  4. Institute of Hematology, Peking University People’s Hospital, Beijing, China

    Xiao-jun Huang

  5. Departement D’Hematologie, Programme de Transplantation et de Therapie Cellulaire, Centre de Recherche en Cancerologie de Marseille, Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  6. Rome Transplant Network, Università Tor Vergata, Roma, Italy

    William Arcese

  7. Hospital Universitario Marqués de Valdecilla, Av., Valdecilla, 25, 39008, Santander, Spain

    Mercedes Colorado Araujo

  8. Assistance Publique-Hôpitaux de Paris, Hematology Stem Cell Transplantation, Saint Louis Hospital, Paris, France

    Gerard Socié

  9. CHU, Bordeaux, France

    Edouard Forcade

  10. Hematology and BMT Unit, San Raffaele Scientific Institute, Milan, Italy

    Fabio Ciceri

  11. Hematology Division, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel

    Jonathan Canaani

  12. Maria Sklodowska-Curie Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland

    Sebastian Giebel

  13. Service d’Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Sorbonne Université, INSERM UMRs 938, Paris, France

    Eolia Brissot

  14. Hospital La Fe, Valencia, Spain

    Jaime Sanz Caballer

  15. Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Ali Bazarbachi

  16. Department of Haematology, Saint Antoine Hospital, INSERM UMR 938 and Sorbonne University, Paris, France

    Ibrahim Yakoub-Agha

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  1. Arnon Nagler
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Contributions

AN, ML, JC, and MM designed the study, analyzed the data and wrote the manuscript. XH, DB, WA, MCA, GS, EF, FC, SG, EB, JS, AB, and IYA collected clinical data. All authors read and approved the final manuscript.

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Correspondence to Arnon Nagler.

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Nagler, A., Labopin, M., Huang, Xj. et al. Non-T depleted haploidentical stem cell transplantation in AML patients achieving first complete remission after one versus two induction courses: a study from the ALWP/EBMT. Bone Marrow Transplant 57, 572–578 (2022). https://doi.org/10.1038/s41409-021-01537-x

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