RIC versus MAC UCBT in adults with AML: A report from Eurocord, the ALWP and the CTIWP of the EBMT
Por:
Baron, F, Ruggeri, A, Beohou, E, Labopin, M, Sanz, G, Milpied, N, Michallet, M, Bacigalupo, A, Blaise, D, Sierra, J, Socie, G, Cornelissen, JJ, Schmid, C, Giebel, S, Gorin, NC, Esteve, J, Ciceri, F, Savani, BN, Mohty, M, Gluckman, E, Nagler, A
Publicada:
12 jul 2016
Resumen:
Nonrelapse mortality (NRM) is the first cause of treatment failure after unrelated cord blood transplantation (UCBT) following myeloablative conditioning (MAC). In the last decade, reduced-intensity conditioning (RIC) regimens have been developed with the aim of reducing NRM and allowing older patients and those with medical comorbidities to benefit from UCBT. The aim of the current retrospective study was to compare transplantation outcomes of acute myeloid leukemia (AML) patients given UCBT after either RIC or MAC. Data from 894 adults with AML receiving a single or double UCBT as first allograft from 2004 to 2013 at EBMT centers were included in this study. 415 patients were given UCBT after RIC while 479 patients following a MAC. In comparison to MAC recipients, RIC recipients had a similar incidence of neutrophil engraftment and of acute and chronic graft-versus-host disease (GVHD). However, RIC recipients had a higher incidence of disease relapse and a lower NRM, translating to comparable leukemia-free (LFS), GVHD-free, relapse-free survival (GRFS) and overall survival (OS). These observations remained qualitatively similar after adjusting for differences between groups in multivariate analyses. In conclusion, these data suggest that LFS and OS are similar with RIC or with MAC in adults AML patients transplanted with UCBT. These observations could serve as basis for a future prospective randomized study.
Filiaciones:
Baron, F:
Univ Liege, Liege, Belgium
Ruggeri, A:
Hosp St Louis, AP HP, Eurocord, Paris, France
IUH Univ Paris VII, Paris, France
Hop St Antoine, AP HP, Hematol Clin & Therapie Cellulaire, Paris, France
Beohou, E:
Hosp St Antoine, EBMT Paris Off, Paris, France
Labopin, M:
Hosp St Antoine, EBMT Paris Off, Paris, France
Sanz, G:
Hosp Univ La Fe, Serv Hematol, Valencia, Spain
Milpied, N:
Hop Haut Leveque, CHU Bordeaux, Hematol Clin & Therapie Cellulaire, Bordeaux, France
Univ Bordeaux, Bordeaux, France
Michallet, M:
Ctr Hosp Lyon Sud, Serv Hematol, Pierre Benite, France
Bacigalupo, A:
Osped San Martino Genova, Dept Haematol 2, Genoa, Italy
Blaise, D:
Aix Marseille Univ, Inst Paoli Calmettes, Ctr Rech Cancerol CRCM, UM105,Inserm U1068,CNRS Marseille UMR7258, Marseille, France
Sierra, J:
Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain
Socie, G:
Hosp St Louis, AP HP, Hematol Transplantat, Paris, France
Cornelissen, JJ:
Erasmus MC, Daniel den Hoed Canc Ctr, Rotterdam, Netherlands
Schmid, C:
Univ Munich, Dept Hematol & Oncol, Klinikum Augsburg, Augsburg, Germany
Giebel, S:
Maria Sklodowska Curie Canc Ctr, Gliwice, Poland
Inst Oncol, Gliwice Branch, Gliwice, Poland
Gorin, NC:
Hop St Antoine, AP HP, Hematol Clin & Therapie Cellulaire, Paris, France
Hosp St Antoine, EBMT Paris Off, Paris, France
Esteve, J:
Hosp Clin Barcelona, Deptartment Hematol, Barcelona, Spain
Ciceri, F:
Univ Milan, Osped San Raffaele, Dept Hematol, Milan, Italy
Savani, BN:
Vanderbilt Univ, Med Ctr, Long Term Transplant Clin, Nashville, TN USA
Mohty, M:
Hop St Antoine, AP HP, Hematol Clin & Therapie Cellulaire, Paris, France
Univ Paris 06, Paris, France
INSERM, UMRs 938, Paris, France
Gluckman, E:
Hosp St Louis, AP HP, Eurocord, Paris, France
IUH Univ Paris VII, Paris, France
Ctr Sci Monaco, Monacord, Monaco, Monaco
Nagler, A:
Hosp St Antoine, EBMT Paris Off, Paris, France
Chaim Sheba Med Ctr, Div Hematol & Bone Marrow Transplantat, Ramat Gan, Israel
Green Published, Hybrid Gold
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