Journal of Hematology & Oncology (Jan 2024)

Bone marrow graft versus peripheral blood graft in haploidentical hematopoietic stem cells transplantation: a retrospective analysis in1344 patients of SFGM-TC registry

  • Claire Lacan,
  • Jérôme Lambert,
  • Edouard Forcade,
  • Marie Robin,
  • Patrice Chevallier,
  • Sandrine Loron,
  • Claude-Éric Bulabois,
  • Corentin Orvain,
  • Patrice Ceballos,
  • Etienne Daguindau,
  • Amandine Charbonnier,
  • Yves Chalandon,
  • Marc Bernard,
  • Célestine Simand,
  • Marie-Thérèse Rubio,
  • Pascal Turlure,
  • Johan Maertens,
  • Anne Huynh,
  • Michael Loschi,
  • Jacques-Olivier Bay,
  • Gaëlle Guillerm,
  • Mustafa Alani,
  • Cristina Castilla-Llorente,
  • Xavier Poiré,
  • Sylvain Chantepie,
  • Natacha Maillard,
  • Yves Beguin,
  • Ambroise Marçais,
  • Jérôme Cornillon,
  • Jean-Valère Malfuson,
  • Sébastien Maury,
  • Nathalie Meuleman,
  • Alban Villate,
  • Mohammed-Amine Bekadja,
  • Anouk Walter-Petrich,
  • Nathalie Jacque,
  • Micha Srour,
  • Raynier Devillier,
  • Stéphanie Nguyen

DOI
https://doi.org/10.1186/s13045-023-01515-4
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 5

Abstract

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Abstract The use of peripheral blood (PB) or bone marrow (BM) stem cells graft in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis remains controversial. Moreover, the value of adding anti-thymoglobulin (ATG) to PTCy is unknown. A total of 1344 adult patients received an unmanipulated haploidentical transplant at 37 centers from 2012 to 2019 for hematologic malignancy. We compared the outcomes of patients according to the type of graft, using a propensity score analysis. In total population, grade II–IV and III–IV acute GVHD (aGVHD) were lower with BM than with PB. Grade III–IV aGVHD was lower with BM than with PB + ATG. All outcomes were similar in PB and PB + ATG groups. Then, in total population, adding ATG does not benefit the procedure. In acute leukemia, myelodysplastic syndrome and myeloproliferative syndrome (AL-MDS-MPS) subgroup receiving non-myeloablative conditioning, risk of relapse was twice greater with BM than with PB (51 vs. 22%, respectively). Conversely, risk of aGVHD was greater with PB (38% for aGVHD II–IV; 16% for aGVHD III–IV) than with BM (28% for aGVHD II–IV; 8% for aGVHD III–IV). In this subgroup with intensified conditioning regimen, risk of relapse became similar with PB and BM but risk of aGVHD III–IV remained higher with PB than with BM graft (HR = 2.0; range [1.17–3.43], p = 0.012).

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