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Hematopoietic stem cell transplantation with unrelated cord blood or haploidentical donor grafts in adult patients with secondary acute myeloid leukemia, a comparative study from Eurocord and the ALWP EBMT

Bone Marrow Transplantation volume 54, pages 1987–1994 (2019)Cite this article

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Abstract

Survival of patients with secondary acute myeloid leukemia (sAML) is poor. Cord blood transplantation (UCBT) and non-T-cell-depleted stem cell transplantation from haploidentical donors (HAPLO) are both strategies that have shown encouraging results in patients who do not have an human leukocyte antigen (HLA)-matched sibling or unrelated donor. We retrospectively analyzed outcomes of 409 adults with sAML receiving either UCBT (n = 163) or HAPLO (n = 246) in EBMT centers. Myelodysplastic syndrome (MDS) or myeloproliferative disorder (MPD) was the antecedent diagnosis in 79% of UCBT and 85% of HAPLO recipients. In multivariate analysis, UCBT was associated with higher risk of grade II–IV acute GVHD (HR 1.9, p = 0.009) and lower GHVD-free-relapse-free-survival (GRFS) (HR 1.57, p = 0.007) compared to HAPLO. Chronic-GVHD, RI, NRM, LFS, and OS were not statistically different between the two. Early disease stage at transplant was independently associated with lower RI and NRM and higher OS and LFS. These results indicate that HAPLO is associated with better GRFS and lower aGvHD compared to UCBT in patients with sAML and that UCBT can be a valid alternative for sAML patients who lack a matched sibling, a proper haploidentical or an unrelated donor.

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Acknowledgements

The authors thank Emmanuelle Polge and Chantal Kenzey for helping with data collection and the association “Cordons de vie”, Monaco.

Author information

Author notes

  1. These authors contributed equally: Mohamad Mohty, Eliane Gluckman, Arnon Nagler

Authors and Affiliations

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

    Annalisa Ruggeri

  2. Hôpital Saint Antoine, Service d’Hématologie et Thérapie Cellulaire, AP-HP, Paris, France

    Myriam Labopin, Annalisa Paviglianiti, Mohamad Mohty & Arnon Nagler

  3. Vanderbilt University Medical Center, Nashville, TN, USA

    Bipin Savani

  4. Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  5. Hôpital Saint Louis, Eurocord, IUH University Paris VII, Paris, France

    Fernanda Volt, Vanderson Rocha & Eliane Gluckman

  6. Monacord, Centre Scientifique de Monaco, Monaco, Monaco

    Fernanda Volt, Vanderson Rocha & Eliane Gluckman

  7. Hematology and BMT Unit, San Raffaele Scientific Institute, Milano, Italy

    Fabio Ciceri

  8. Hematology Department, Fondazione Policlinico Universitario Agostino Gemelli, Universita’ Cattolica deI Sacro Cuore, Rome, Italy

    Andrea Bacigalupo

  9. Ludwig Maximilian University Hospital of Munich, Munich, Germany

    Johanna Tischer

  10. Service d’hématologie, Hôtel Dieu, Nantes, France

    Patrice Chevallier

  11. Medical Park, Stem Cell Transplant Unit, Antalya, Turkey

    Yener Koc

  12. Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands

    Jan J. Cornelissen

  13. Universitätsklinikum Carl Gustav Carus der TU Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany

    Gerard Ehninger

  14. Hospital Universitario y Politécnico La Fe, Valencia, Spain

    Guillermo Sanz

  15. CIBERONC, Madrid, Spain

    Guillermo Sanz

  16. Hopital Jean Minjoz, Service d’Hématologie, Besançon, France

    Erick Deconinck

  17. Department of Hematology, CHU of Liège, 4000, Liège, Belgium

    Frederic Baron

  18. INSERM, UMRs 938, Paris, France

    Mohamad Mohty

  19. Chaim Sheba Medical Center, Tel-Hashomer, Israel

    Arnon Nagler

Authors
  1. Annalisa Ruggeri
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Contributions

AR, ML, and AN designed the study. AR and AP wrote the paper. AR and ML performed the statistical analysis. AP and FV helped with data and manuscript preparation. BS, DB, FC, AB, JT, PC, YK, JJC, GS, ED, VR, FB, MM, EG provided cases for the study. All authors edited and approved the manuscript.

Corresponding author

Correspondence to Annalisa Ruggeri.

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Conflict of interest

Frederic Baron has received travel grants from Celgene, Abbvie, Novartis and Sanofi. The remaining authors declare that they have no conflict of interest.

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Ruggeri, A., Labopin, M., Savani, B. et al. Hematopoietic stem cell transplantation with unrelated cord blood or haploidentical donor grafts in adult patients with secondary acute myeloid leukemia, a comparative study from Eurocord and the ALWP EBMT. Bone Marrow Transplant 54, 1987–1994 (2019). https://doi.org/10.1038/s41409-019-0582-5

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  • DOI: https://doi.org/10.1038/s41409-019-0582-5

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