Haploidentical transplant with post-transplant cyclophosphamide for T-cell acute lymphoblastic leukemia: a report from the EBMT acute leukemia working party

Bazarbachi A, Labopin M, Angelucci E, Gülbas Z, Ozdogu H, Arat M, De Rosa L, Pastano R, Pioltelli P, Montserrat R, Martino M, Ciceri F, Koç Y, Socie G, Blaise D, Herrera Arroyo C, Chalandon Y, Bernasconi P, Marotta G, Castagna L, Mcdonald A, Visani G, Carluccio P, Vitek A, Simand C, Afanasyev B, Rösler W, Diez-Martin JL, Nagler A, Brissot E, Giebel S, Mohty M (2020)

Publication Type: Journal article

Publication year: 2020

Journal

DOI: 10.1016/j.bbmt.2020.01.003

Abstract

Allogeneic hematopoietic cell transplantation (HCT) is recommended in high-risk patients with T cell acute lymphoblastic leukemia (T-ALL). For patients with no HLA identical donor, haploidentical transplantation (haplo-HCT) is becoming the leading source of stem cell donation. However, data is scarce on predictive factors for outcome in that setting. We identified 122 adults (20% female; median age 31 years; range 18-68) with T-ALL who received a haplo-HCT with post-transplant cyclophosphamide (ptCy) between 2010 and 2017. Median follow-up of living patients was 23 months. The 2-year relapse incidence and non-relapse mortality were 45% and 21%, respectively. The 2-year leukemia-free survival (LFS), overall survival (OS) and GVHD-free, relapse-free survival (GRFS) were 34%, 42% and 27%, respectively. The 2-year LFS and OS were highly influenced by disease status at transplant, being 49% and 55% respectively for first complete remission (CR1), 34% and 50% respectively for CR2, 8% and 12% respectively for patients with active disease. On multivariate analysis, only disease status affected LFS and OS. Transplantation in CR2 negatively affected LFS, whereas active disease at haplo-HCT negatively affected LFS and OS. In conclusion, haplo-HCT with ptCy produced encouraging results in this challenging disease, particularly when performed in CR. Despite the limitation of the small sample size, results were not affected by the type of conditioning, questioning the need for total body irradiation based-myeloablative conditioning (TBI-MAC) in that setting.

Authors with CRIS profile

Involved external institutions

Hospital Universitario Reina Sofía de Córdoba Edificio IMIBIC Spain (ES) Hôpital Saint-Antoine France (FR) Hospital General Universitario Gregorio Marañón Spain (ES) Istanbul Florence Nightingale Hospital Turkey (TR) Başkent University Hospital Turkey (TR) University Hospital Siena Italy (IT) Azienda Ospedaliera San Gerardo (ASST Monza) Italy (IT) Azienda ospedaliera San Camillo-Forlanini Italy (IT) Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal France (FR) Policlinico San Matteo Pavia Fondazione IRCCS Italy (IT) Ospedale San Raffaele (früher: Centro San Raffaele del Monte Tabor Foundation) Italy (IT) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL) Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari Italy (IT) Hôpitaux universitaires de Strasbourg (HUS) / University Hospital Strasbourg France (FR) American University of Beirut (AUB) / الجامعة الأميركية في بيروت‎‎ Lebanon (LB) Anadolu Medical Center Turkey (TR) Ospedale San Martino (IRCCS AOU) Italy (IT) Istituto Clinico Humanitas Italy (IT) CRCM Centre de Recherche en Cancérologie de Marseille France (FR) Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie Poland (PL) Netcare Pretoria East Hospital South Africa (ZA) European Institute of Oncology / Istituto Europeo di Oncologia (IEO) Italy (IT) Hospital Clínic de Barcelona Spain (ES) Geneva University Hospitals / Hôpitaux universitaires de Genève (HUG) Switzerland (CH) Medicana Turkey (TR) Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria Italy (IT) First Pavlov State Medical University of St. Petersburg Russian Federation (RU) Presidio Ospedaliero San Salvatore Italy (IT) Institute of Hematology and Blood Transfusion (IHBT) / Ústav hematologie a krevní transfuze (ÚHKT) Czech Republic (CZ)

How to cite

APA:

Bazarbachi, A., Labopin, M., Angelucci, E., Gülbas, Z., Ozdogu, H., Arat, M.,... Mohty, M. (2020). Haploidentical transplant with post-transplant cyclophosphamide for T-cell acute lymphoblastic leukemia: a report from the EBMT acute leukemia working party. Biology of Blood and Marrow Transplantation. https://doi.org/10.1016/j.bbmt.2020.01.003

MLA:

Bazarbachi, Ali, et al. "Haploidentical transplant with post-transplant cyclophosphamide for T-cell acute lymphoblastic leukemia: a report from the EBMT acute leukemia working party." Biology of Blood and Marrow Transplantation (2020).

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