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CD34-selected allogeneic hematopoietic cell transplantation for chronic myeloid leukemia in the tyrosine kinase era

Bone Marrow Transplantation volume 57, pages 1740–1742 (2022)Cite this article

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Allogeneic hematopoietic cell transplantation (HCT) is an important treatment option for patients with chronic myeloid leukemia who are resistant to tyrosine kinase inhibitors (TKIs), intolerant of TKIs, or who develop an accelerated phase or blast crisis. Graft-versus-host disease (GVHD)—the immunologic reaction of donor cells against normal host tissue—is a major complication after allogeneic HCT, limiting the application and success of this procedure. Allogeneic HCT using ex-vivo selection of CD34-positive hematopoietic cells is one strategy for reducing the incidence of GVHD [1,2,3,4,5]. However, there are limited published data describing the outcomes of patients who received CD34-selected grafts in the contemporary time period. The purpose of this study was to report the outcomes of 24 patients who received CD34-selected allografts and compare their outcomes to 16 patients who received unmodified grafts at Memorial Sloan Kettering Cancer Center.

We included adults who received their first allogeneic HCT for CML at our institution between 2010–2020. Written informed consent for treatment was obtained from all patients and donors. Approval for this retrospective review was obtained from the Institutional Review Board and Privacy Board. The study outcomes were overall survival (OS), grade II-IV acute GVHD, chronic GVHD (mild, moderate, and severe), relapse, and non-relapse mortality (NRM). Relapse was defined as previously described [6]. The study outcomes were estimated using nonparametric methods. For acute and chronic GVHD, relapse and death without GVHD were considered competing events. For relapse, NRM was considered a competing event. For NRM, relapse was considered a competing event. The difference in OS between patients receiving CD34-selected and unmodified grafts was tested using the log-rank test. Differences in cumulative incidences were tested using Gray’s test. The association between CD34-selection and each study outcome was also estimated using univariable Cox proportional hazards models. P values less than 0.05 were considered significant. All analyses were performed using R version 4.0.3.

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Fig. 1: Outcomes of patients with CML receiving unmodified (n = 16) and CD34-selected (n = 24) allografts.

Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

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

    John L. Vaughn, Esperanza B. Papadopoulos, Ann A. Jakubowski, Roni Tamari, Sergio A. Giralt, Doris M. Ponce, Christina Cho, Miguel-Angel Perales, Brian C. Shaffer & Boglarka Gyurkocza

  2. Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Samantha Brown

  3. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    Esperanza B. Papadopoulos, Ann A. Jakubowski, Roni Tamari, Sergio A. Giralt, Doris M. Ponce, Christina Cho, Miguel-Angel Perales, Brian C. Shaffer & Boglarka Gyurkocza

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  1. John L. Vaughn
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  11. Boglarka Gyurkocza
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Contributions

Conceptualization: All authors. Data curation: JLV. Formal analysis: JLV and SB. Writing—Original Draft: JLV. Writing—Review and Editing: All Authors.

Corresponding author

Correspondence to Boglarka Gyurkocza.

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Competing interests

SAG receives research funding from Miltenyi Biotec, Takeda Pharmaceutical Co., Celgene Corp., Amgen Inc., Sanofi, Johnson and Johnson, Inc., Actinium Pharmaceuticals, Inc., and is on the Advisory Boards for: Kite Pharmaceuticals, Inc., Celgene Corp., Sanofi, Novartis, Johnson and Johnson, Inc., Amgen Inc., Takeda Pharmaceutical Co., Jazz Pharmaceuticals, Inc., Actinium Pharmaceuticals, Inc. MAP reports honoraria from Abbvie, Allovir, Astellas, Bristol-Myers Squibb, Celgene, Equilium, Exevir, Incyte, Karyopharm, Kite/Gilead, Merck, Miltenyi Biotec, MorphoSys, Novartis, Nektar Therapeutics, Omeros, OrcaBio, Takeda, and VectivBio AG, Vor Biopharma. He serves on DSMBs for Cidara Therapeutics, Medigene, Sellas Life Sciences, and Servier, and the scientific advisory board of NexImmune. He has ownership interests in NexImmune and Omeros. He has received institutional research support for clinical trials from Incyte, Kite/Gilead, Miltenyi Biotec, Nektar Therapeutics, and Novartis. BCS reports consulting for Hansa Biopharma and Gamida Cell. BG has received institutional research support for clinical trials from Actinium Pharmaceuticals.

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Vaughn, J.L., Brown, S., Papadopoulos, E.B. et al. CD34-selected allogeneic hematopoietic cell transplantation for chronic myeloid leukemia in the tyrosine kinase era. Bone Marrow Transplant 57, 1740–1742 (2022). https://doi.org/10.1038/s41409-022-01783-7

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