T-cell-replete haploidentical transplantation versus autologous stem cell transplantation in adult acute leukemia: a matched pair analysis
Norbert-Claude Gorin,
Myriam Labopin,
Simona Piemontese,
William Arcese,
Stella Santarone,
He Huang,
Giovanna Meloni,
Felicetto Ferrara,
Dietrich Beelen,
Miguel Sanz,
Andrea Bacigalupo,
Fabio Ciceri,
Audrey Mailhol,
Arnon Nagler,
Mohamad Mohty
Affiliations
Norbert-Claude Gorin
APHP, Acute Leukemia Working Party–EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France;Sorbonne Universités, UPMC University Paris 06, France;INSERM UMR-S 938, Paris, France
Myriam Labopin
APHP, Acute Leukemia Working Party–EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France;Sorbonne Universités, UPMC University Paris 06, France;INSERM UMR-S 938, Paris, France
Simona Piemontese
APHP, Acute Leukemia Working Party–EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France;Ospedale San Raffaele s.r.l. Via Olgettina 60, Milan, Italy
William Arcese
Rome Transplant Network, Tor Vergata University of Rome, Stem Cell Transplant Unit, Policlinico Universitario Tor Vergata, Rome, Italy
Stella Santarone
Ospedale Civile, Department of Hematology, Fonte Romana 8, Pescara, Italy
He Huang
First Affiliated Hospital, Zhejiang University, Bone Marrow Transplantation Center, Hangzhou Zhejiang, China
Giovanna Meloni
University La Sapienza, Rome, Italy
Felicetto Ferrara
Cardarelli Hospital, Napoli, Italy
Dietrich Beelen
University Hospital, Dept. of Bone Marrow Transplantation, Essen, Germany
Miguel Sanz
Hospital Universitario La Fe, University of Valencia, Spain
Andrea Bacigalupo
Ospedale San Martino, Department of Haematology II, Genova, Italy
Fabio Ciceri
Ospedale San Raffaele s.r.l. Via Olgettina 60, Milan, Italy
Audrey Mailhol
APHP, Acute Leukemia Working Party–EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France
Arnon Nagler
Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel
Mohamad Mohty
APHP, Acute Leukemia Working Party–EBMT and Department of Hematology and Cell Therapy, Höpital Saint-Antoine, Paris, France;Sorbonne Universités, UPMC University Paris 06, France;INSERM UMR-S 938, Paris, France
Adult patients with acute leukemia in need of a transplant but without a genoidentical donor are usually considered upfront for transplantation with stem cells from any other allogeneic source, rather than autologous stem cell transplantation. We used data from the European Society for Blood and Marrow Transplantation and performed a matched pair analysis on 188 T-cell-replete haploidentical and 356 autologous transplants done from January 2007 to December 2012, using age, diagnosis, disease status, cytogenetics, and interval from diagnosis to transplant as matching factors. “Haploidentical expert” centers were defined as having reported more than five haploidentical transplants for acute leukemia (median value for the study period). The median follow-up was 28 months. Multivariate analyses, including type of transplant categorized into three classes (“haploidentical regular”, “haploidentical expert” and autologous), conditioning intensity (reduced intensity versus myeloablative conditioning) and the random effect taking into account associations related to matching, showed that non-relapse mortality was higher following haploidentical transplants in expert (HR: 4.7; P=0.00004) and regular (HR: 8.98; P
