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Peripheral blood haploidentical hematopoietic cell transplantation for patients aged 70 years and over with acute myeloid leukemia or high-risk myelodysplastic syndrome

Bone Marrow Transplantation volume 59, pages 101–106 (2024)Cite this article

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Abstract

Haploidentical stem cell transplantation (Haplo-SCT) using non-myeloablative conditioning regimen (NMAC) has extended the feasibility of allogeneic transplantation, notably in older patients. However, there is few data specifically focusing on patients aged 70 years and over with AML and MDS. Thus the benefit of transplantation in this population is still debated. Here we report our single center experience of peripheral blood Haplo-SCT with NMAC and post-transplantation cyclophosphamide in AML and MDS patients aged 70 years and over. We analyzed 50 patients (27 AML, 23 MDS) with a median age of 72 years (70–77), 12/50 (24%) with active disease at Haplo-SCT. Cumulative incidence of grade 3–4 acute and moderate or severe chronic GVHD were 6% and 25%, respectively. Non-relapse mortality (NRM) at day +100 was 0%. NRM, relapse, PFS and OS at 3 years were 16%, 18%, 66%, and 69%, respectively. Among patients who were disease free at 2 years post Haplo-SCT, 88% are living without immunosuppressive treatment. Peripheral blood Haplo-SCT is feasible in selected AML/MDS patients over 70 years, without any early NRM. It produces long-term disease control and survival. Thus, age by itself should not be considered as a formal barrier to Haplo-SCT.

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Fig. 1: Impact of pDLI on survivals after Haplo-SCT.
Fig. 2: Prevalence GVHD and Immunosuppression after Haplo-SCT.
Fig. 3: Ouctome after Haplo-SCT.

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On request to corresponding author.

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Acknowledgements

We thank the patients and their family, and the IPC transplantation staff.

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Authors and Affiliations

  1. Hematology Department, Institut Paoli-Calmettes, Marseille, France

    Samia Harbi, Louison Brac de la Perriere, Benjamin Bouchacourt, Thomas Pagliardini, Maud Cecile, Yosr Hicheri, Marie-Anne Hospital, Sabine Fürst, Cécile Braticevic, Faezeh Legrand, Elena Bekrieva & Pierre-Jean Weiller

  2. Hematology Department, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France

    Sylvain Garciaz, Anne-Charlotte Lefloch, Norbert Vey, Didier Blaise & Raynier Devillier

  3. Cell Therapy Facility, Institut Paoli-Calmettes, CIC-biotherapy, Marseille, France

    Boris Calmels, Claude Lemarie & Christian Chabannon

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SH, LBdlP, MC, CB, and RD collected data. SH and RD analyzed data and wrote the manuscript. All authors edited the manuscript and approved its submission.

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Correspondence to Raynier Devillier.

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Harbi, S., Brac de la Perriere, L., Bouchacourt, B. et al. Peripheral blood haploidentical hematopoietic cell transplantation for patients aged 70 years and over with acute myeloid leukemia or high-risk myelodysplastic syndrome. Bone Marrow Transplant 59, 101–106 (2024). https://doi.org/10.1038/s41409-023-02134-w

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