Autologous Cord Blood Cells Infusion as Salvage Therapy for Engraftment Failure After Haploidentical Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia

Rojas, Teresa de; Fioravantti, Victoria; Deltoro, Natalia; Andión, Maitane; González‐Vicent, Marta; Madero, Luís

doi:10.1002/pbc.25974

Cited by 2 publications

(1 citation statement)

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“…Although none of them survived allotransplant, the series is too small to conclude on the inefficacy of this procedure. It must also be kept in mind that CB transplant, even if its incidence is decreasing in adults, remains a valid alternative in case of urgent transplantation in patients with no matched or haplo donors or as a salvage option in patients presenting with primary or secondary graft failure after haplo transplants [36]. Moreover, emerging haplo-CB transplants could present some advantage over CB transplant alone [37].…”

Section: Discussionmentioning

confidence: 99%

Influence of Donor Type (Sibling versus Matched Unrelated Donor versus Haploidentical Donor) on Outcomes after Clofarabine-Based Reduced-Intensity Conditioning Allograft for Myeloid Malignancies

Bouard¹,

Guillaume

Péterlin³

et al. 2019

Biology of Blood and Marrow Transplantation

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Clofarabine-based reduced-intensity conditioning (RIC) regimens are well-established schedules for allograft in patients with myeloid malignancies. A retrospective study was conducted including all adults allografted in our department with such a regimen and disease with the aim to assess whether or not the donor type (matched sibling [MSD], matched unrelated [MUD], or haploidentical [haplo]) impacted outcomes. Between October 2009 and February 2018, 118 patients met the inclusion criteria. Thirty-six, 55, and 27 patients received a graft from an MSD, MUD, or haplo donor, respectively. Peripheral blood stem cells (PBSCs) were the source of graft for all patients. The median age of the entire cohort was 62 years (range, 20 to 73), and the median follow-up was 31 months (range, 4.5 to 106). All patients engrafted except 1 haplo recipient. Neutrophils (>.5 £ 10 9 /L) and platelets (50 £ 10 9 /L) recoveries were significantly delayed in the haplo group (P = .0003 and P < .0001) compared with MSD and MUD. Acute grades II to IV or III to IV graft-versus-host disease (GVHD) incidences were similar between the 3 groups as well as the incidence of moderate or severe chronic GVHD. Also, similar 2-year overall survival (OS; 64.7% versus 73.9% versus 60.2%, P = .39), disease-free survival (DFS; 57.7% versus 70.9% versus and 53.6%, P = .1), and GVHD relapse-free survival (37.9% versus 54.3% versus 38.9%, P = .23) were observed between MSD versus MUD versus haplo groups. The same was true when considering only acute myeloid leukemia (AML) cases. In multivariate analysis the type of donor remained independent of outcomes in this series, whereas myelodysplastic syndrome (versus AML), high disease risk index, and older donor (50 years) were associated with lower OS and DFS. These data suggest that haplo donors are an acceptable alternative for patients receiving a clofarabine-based RIC PBSC allograft for myeloid malignancies who lack an MSD or a MUD.

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Section: Discussionmentioning

confidence: 99%