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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), 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 respectively received a graft from a MSD, MUD or haplo donor. Peripheral blood stem cells (PBSC) were the source of graft for all patients. The median age of the whole cohort was 62 years old (range: 20-73) and the median follow-up was 31 months (range: 4.5-106). All patients engrafted except 1 haplo recipient. Neutrophils (>0.5 10/L) and platelets (50 10/L) recoveries were significantly delayed in the haplo-group (p=0.0003; and p<0.0001) compared to MSD and MUD. Acute grade 2-4 or 3-4 graft versus host disease (GVHD) incidences were similar between the three groups as well as the incidence of moderate or severe chronic GVHD. Also, similar 2-year overall survival (OS, 64.7% vs 73.9% vs 60.2%, p=0.39), disease-free survival (DFS, 57.7% vs 70.9% vs and 53.6%, p=0.1) and GVHD-relapse free survival (37.9% vs 54.3% vs 38.9%, p=0.23) were observed between MSD vs MUD vs 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 while myelodysplastic syndrome (vs AML), high disease-risk index and older donor (>=50 years) were associated with lower OS and DFS. These data suggest that haplo-identical donors are an acceptable alternative for patients receiving a clofarabine-based RIC PBSC allograft for myeloid malignancies who lack a MSD or a MUD.
This article was published in the following journal.
Patients with primary immunodeficiencies (PIDs) are potentially cured by allogeneic hematopoietic cell transplantation (HCT). The spectrum of PIDs has expanded greatly beyond those that present in inf...
Haploidentical transplantations have achieved comparable survival as HLA fully matched unrelated donors. When choosing the best donor for HLA-haploidentical transplantations, most institutions priorit...
Comparison of outcomes of frontline immunosuppressive therapy and frontline haploidentical hematopoietic stem cell transplantation for children with severe aplastic anemia who lack an HLA-matched sibling donor.
We compared the outcomes of immunosuppressive treatment (IST) with those of replete haploidentical donor hematopoietic stem cell transplantation (haplo-HSCT) in children and adolescents with severe ap...
Alternative donor allogeneic hematopoietic cell transplants (allo-HCT), such as double UCB transplants (dUCBT) and haploidentical related donor transplants (haplo-HCT) have been shown to be safe and e...
T cell-replete haploidentical stem cell transplantation (haplo-SCT) is a valid therapeutic option for adult patients with high-risk acute myeloid leukemia (AML) lacking an HLA-matched sibling or unrel...
Historically, the best results of allogeneic SCT have been obtained when the stem cell donor is a human leukocyte antigen (HLA)-matched sibling, however, this is only available for approxi...
The Rapid Study: Randomized Phase II Study To Expedite Allogeneic Transplant With Immediate Haploidentical Plus Unrelated Cord Donor Search Versus Matched Unrelated Donor Search For AML And High-Risk MDS Patients
The study seeks to compare time from formal search to hematopoietic cell transplantation (HCT) for patients 18 years and older, randomized between haplo-cord search and matched unrelated d...
With this protocol the ALL-SCT BFM international study group wants - to evaluate whether hematopoietic stem cell transplantation (HSCT) from matched family or unrelated donors (MD...
Subjects will be diagnosed with a hematological malignancy (cancer of the blood), which is unlikely to be cured with conventional non-transplant therapy. The best results of bone marrow t...
This study aimed to evaluate the efficacy of reduced intensity conditioning (RIC) regimen in low- and intermediate-risk myelodysplastic syndrome (MDS) patients who receive haploidentical h...
A mismatch between donor and recipient blood. Antibodies present in the recipient's serum are directed against antigens in the donor product. Such a mismatch may result in a transfusion reaction in which, for example, donor blood is hemolyzed. (From Saunders Dictionary & Encyclopedia of Laboratory Medicine and Technology, 1984)
The transfer of lymphocytes from a donor to a recipient or reinfusion to the donor.
The transfer of erythrocytes from a donor to a recipient or reinfusion to the donor.
The transfer of leukocytes from a donor to a recipient or reinfusion to the donor.
The transfer of blood platelets from a donor to a recipient or reinfusion to the donor.
Track and monitor developments in stem cell research and commercial development. Follow the tabs above to read the latest global news, research, clinical trials on stem cells and follow companies active in the stem cell industry. BioPort...
Blood is a specialized bodily fluid that delivers necessary substances to the body's cells (in animals) – such as nutrients and oxygen – and transports waste products away from those same cells. In vertebrates, it is composed of blo...
Leukemia is a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called "blasts". Leukemia is a broad term covering a spectrum of diseases. In turn, it is part of the even broader grou...