Allogeneic hematopoietic cell transplantation with cord blood versus mismatched unrelated donor with post-transplant cyclophosphamide in acute myeloid leukemia

Dholaria, Bhagirathbhai; Labopin, Myriam; Sanz, Jaime; Ruggeri, Annalisa; Cornelissen, Jan J.; Labussière‐Wallet, Hélène; Blaise, Didier; Forcade, Édouard; Chevallier, Patrice; Grassi, Anna; Zubarovskaya, Ludmila; Kuball, Jürgen; Céballos, Patrice; Ciceri, Fabio; Baron, Frédéric; Savani, Bipin N.; Nagler, Arnon; Mohty, Mohamad

doi:10.1186/s13045-021-01086-2

Cited by 14 publications

(28 citation statements)

References 48 publications

(44 reference statements)

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“…A total of 3336 patients from 19 studies were included in this systematic review and meta-analysis, with a median age of 52.1 (6-76.5) years (16,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), and 53% (n=1659/3116) of recipients were male (20)(21)(22)(23)(24)(25)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). Eighty-six percent (n=1055/1222) patients were Caucasian and 5.8% (n=71/1222) were African American (30-16).…”

Section: Resultsmentioning

confidence: 99%

“…Eighty-six percent (n=1055/1222) patients were Caucasian and 5.8% (n=71/1222) were African American (30-16). The primary graft source was bone marrow (BM) in 19% (n=646/3336) and peripheral blood stem cells (PBSC) in 81% (n=2690/3336) of the recipients (16,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). The median time to transplant was 10 (1-247) months (15,20,(22)(23)(24)28) and median follow-up time was 33 (0.4-135.6) months (16, 20-22, 24-32, 34-37).…”

Section: Resultsmentioning

confidence: 99%

“…The primary graft source was bone marrow (BM) in 19% (n=646/3336) and peripheral blood stem cells (PBSC) in 81% (n=2690/3336) of the recipients (16,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). The median time to transplant was 10 (1-247) months (15,20,(22)(23)(24)28) and median follow-up time was 33 (0.4-135.6) months (16, 20-22, 24-32, 34-37). Reduced-intensity conditioning (RIC) conditioning was used for 65.6% (n=2191) of the patients while 32% (n=1066) of patients received myeloablative conditioning (MAC).…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies, including 3169 patients, did not use PT-Cy for GVHD prophylaxis. The median age was 51.7 (6-76.5) years (16,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32), and 56.5% (n=1614/2859) recipients were male (20)(21)(22)(23)(24)(25)(27)(28)(29)(30)(31)(32). The graft source was BM in 17% (n=546/3169) and PBSC in 82% (n=2623/3169) of the recipients (16,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

Section: Outcomes After Mmud Hsct Without Post-transplant Cyclophosph...mentioning

confidence: 99%

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Outcomes with mismatched unrelated donor allogeneic hematopoietic stem cell transplantation in adults: A systematic review and meta-analysis

Mushtaq

Shahzad²,

Tariq³

et al. 2022

Front. Oncol.

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BackgroundAllogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for various hematologic disorders. Alternative donor strategies such as mismatched unrelated donors (MMUD) offer the option of HSCT to patients lacking a human leukocyte antigen (HLA)-matched donor. We conducted a systematic review and meta-analysis to evaluate outcomes after MMUD-HSCT.MethodsA literature search was performed on PubMed, Cochrane Library, and ClinicalTrials.gov from the inception date through April 6, 2022. After screening 2477 manuscripts, 19 studies were included. Data was extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Pooled analysis was done using the meta-package by Schwarzer et al. Proportions with 95% confidence intervals (CI) were computed.ResultsA total of 3336 patients from 19 studies were included. The median age was 52.1 years, and 53% of recipients were males. The graft source was bone marrow in 19% and peripheral blood stem cells in 81% of recipients. The median time to transplant from hematologic diagnosis was 10 (1-247) months. Hematologic diagnoses included myeloid (82.9%), lymphoid (41.1%), and other disorders (3%). The reduced intensity and myeloablative conditioning were used in 65.6% and 32% of recipients, respectively. In-vivo T-cell depletion was performed in 56.7% of the patients. Most patients had one (87.9%) or two (11.4%) antigen HLA-mismatch. The pooled 1-year overall survival (OS) was 63.9% (95% CI 0.57-0.71, n=1426/2706), and the pooled 3-year OS was 42.1% (95% CI 0.34.2-0.50, n=907/2355). The pooled progression-free survival was 46.6% (95% CI 0.39-0.55, n=1295/3253) after a median follow-up of 1.8 (range 1-6) years. The pooled relapse rate was 26.8% (95% CI 0.22-0.32, n=972/3253) after a median follow-up of 2.25 (1-3) years. The pooled incidence of acute (grade II-IV) graft-versus-host disease (GVHD) and chronic GVHD was 36.4% (95% CI 0.31-0.42, n=1131/3030) and 41.2% (95% CI 0.35-0.48, n=1337/3228), respectively. The pooled non-relapse mortality was 22.6% (95% CI 0.17-0.29, n=888/3196) after a median follow-up of 2.6 (1-5) years.ConclusionMMUD-HSCT has demonstrated favorable outcomes with an acceptable toxicity profile. It represents a promising option in patients lacking an HLA-matched or haploidentical donor and may expand HSCT access to underrepresented racial and ethnic populations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Outcomes After Mmud Hsct Without Post-transplant Cyclophosph...mentioning

confidence: 99%

See 2 more Smart Citations

Outcomes with mismatched unrelated donor allogeneic hematopoietic stem cell transplantation in adults: A systematic review and meta-analysis

Mushtaq

Shahzad²,

Tariq³

et al. 2022

Front. Oncol.

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“…iv) CBFB-MYH11-positive AML patients with CBFB-MYH11/ABL levels >0.1% after two cycles of consolidation therapy (62). Third, other indications include secondary AML, therapy-related AML, and relapsed or refractory AML (R/R AML) (63,(66)(67)(68)(69)(70)(71)(72)(73)(74)(75) (Tables 1-3).…”

Section: Current Therapies For Aml With Haploidentical Allografts Extension Of Haploidentical Transplant Indications For Amlmentioning

confidence: 99%

Haploidentical Stem Cell Transplantation for Acute Myeloid Leukemia: Current Therapies, Challenges and Future Prospective

Chang

Zhao

2021

Front. Oncol.

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Haploidentical stem cell transplantation (haplo-SCT), an alternative donor source, offers a curative therapy for patients with acute myeloid leukemia (AML) who are transplant candidates. Advances in transplantation techniques, such as donor selection, conditioning regimen modification, and graft-versus-host disease prophylaxis, have successfully improved the outcomes of AML patients receiving haplo-SCT and extended the haploidentical transplant indictions for AML. Presently, treating de novo AML, secondary AML, therapy-related AML and refractory and relapsed AML with haplo-SCT can achieve comparable outcomes to those of human leukocyte antigen (HLA)-matched sibling donor transplantation (MSDT), unrelated donor transplantation or umbilical cord blood transplantation. For some subgroups of AML subjects, such as patients with positive pretransplantation minimal/measurable residual disease, recent studies suggest that haplo-SCT might be superior to MSDT in decreasing relapse and improving survival. Unfortunately, for patients with AML after haplo-SCT, relapse and infections remain the causes of death that restrict further improvement in clinical outcomes. In this review, we discuss the recent advances and challenges in haplo-SCT for AML treatment, mainly focusing on unmanipulated haplo-SCT protocols. We provide an outlook on future prospects and suggest that relapse prophylaxis, intervention, and treatment, as well as infection prevention and therapy, are areas of active research in AML patients who receive haploidentical allografts.

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Acute Myeloid Leukemia in Adults: Mast Cell Leukemia and Other Mast Cell Neoplasms

Stone¹,

Schiffer²,

DeAngelo³

2022

Holland‐Frei Cancer Medicine

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Overview Acute myeloid leukemia (AML) is a heterogeneous disease characterized by unbridled proliferation of myeloid stem cells resulting in bone marrow failure and death without effective therapy. The median age of AML is approximately 70; predisposing factors include inherited mutations, exposure to industrial solvents, ionizing radiation, or certain chemotherapy given for other malignancies or conditions. The disease results from the accumulation of mutations in pathways that promote cellular proliferation or impairing differentiation. Prognosis is based on a combination of host and disease factors, especially diagnostic cytogenetics and genomics. In younger fit patients, therapy consists of myelosuppressive induction chemotherapy to minimize disease burden and allow restoration of normal hematopoiesis. Postremission chemotherapy with additional myelo‐intense chemotherapy and/or allogeneic stem cell transplant is required to potentiate cure. In older and less fit patients (perhaps those with adverse prognosis) the current standard is repetitive cycles of a hypomethylating agent or low‐dose cytarabine plus the BCL‐2 inhibitor, venetoclax. The application of molecularly targeted therapies at both diagnosis and relapse may change the natural history of the disease, the management of which requires a comprehensive integration of disparate fields including social work, nutrition, pharmacy, blood bank, and medical oncology.

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Allogeneic hematopoietic cell transplantation with cord blood versus mismatched unrelated donor with post-transplant cyclophosphamide in acute myeloid leukemia

Cited by 14 publications

References 48 publications

Outcomes with mismatched unrelated donor allogeneic hematopoietic stem cell transplantation in adults: A systematic review and meta-analysis

Outcomes with mismatched unrelated donor allogeneic hematopoietic stem cell transplantation in adults: A systematic review and meta-analysis

Haploidentical Stem Cell Transplantation for Acute Myeloid Leukemia: Current Therapies, Challenges and Future Prospective

Acute Myeloid Leukemia in Adults: Mast Cell Leukemia and Other Mast Cell Neoplasms

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