GVHD occurrence does not reduce AML relapse following PTCy-based haploidentical transplantation: a study from the ALWP of the EBMT

Journal of Hematology & Oncology

Correspondence

Johanna Tischer¹  Patrice Chevallier²  Patrizia Chiusolo³  Arnon Nagler⁴  Renato Fanin⁵  Myriam Labopin⁶  Mohamad Mohty⁶  Fabio Ciceri⁷  Anna Maria Raiola⁸  Jan Vydra⁹  Frédéric Baron^1,10  Didier Blaise^1,11  Friedrich Stölzel^1,12 

[1] Department of Internal Medicine III, LMU, University Hospital of Munich, Campus Grosshadern, Munich, Germany;Dept. D`Hematologie, CHU Nantes, Nantes, France;Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel;Division of Hematology, Azienda Ospedaliero Universitaria di Udine, Udine, Italy;EBMT Paris Study Office/CEREST-TC, Paris, France;Department of Hematology, Saint Antoine Hospital, Paris, France;INSERM UMR 938, Paris, France;Sorbonne University, Paris, France;Haematology and BMT, Ospedale San Raffaele S.R.L., Milan, Italy;IRCCS Ospedale Policlinico San Martino, Genoa, Italy;Institute of Hematology and Blood Transfusion, Prague, Czech Republic;Laboratory of Hematology, GIGA-I3, University of Liege and CHU of Liège, Sart-Tilman, 4000, Liège, Belgium;Programme de Transplantation et d’immunothérapie Cellulaire, Management Sport Cancer Lab, Institut Paoli Calmettes, Aix Marseille University, Marseille, France;University Hospital Dresden, Medizinische Klinik und Poliklinik, TU Dresden, Dresden, Germany;University Hospital Schleswig-Holstein, Kiel, Germany;

关键词: AML;    Acute myeloid leukemia;    HLA-haploidentical;    Mismatched unrelated donor;    Post-transplant cyclophosphamide;    PTCy;   

DOI  :  10.1186/s13045-023-01403-x

 received in 2022-12-05, accepted in 2023-01-20,  发布年份 2023

来源: Springer

【 摘 要 】

The association between graft-versus-host disease (GVHD) occurrence and acute myeloid leukemia (AML) relapse in patients treated with HLA-haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HCT) with post-transplant cyclophosphamide (PTCy)-based GVHD prophylaxis has remained debated. Here, we addressed this issue in patients with active AML at transplantation. 2-year cumulative incidences of relapse and leukemia-free survival (LFS) were 49% and 32.3%, respectively. There were no associations between acute nor chronic GVHD of any grade and lower relapse incidence. However, grade I acute GVHD was associated with better LFS (HR = 0.71, 95% CI 0.51–0.99, P = 0.04). In contrast, grade III–IV acute (HR = 3.09, 95% CI 1.87–5.12, P < 0.0001) as well as extensive chronic (HR = 3.3, 95% CI 1.81–6.04, P = 0.0001) GVHD correlated with higher nonrelapse mortality leading to lower LFS (HR = 1.36, 95% CI 0.99–1.86, P = 0.056 and HR = 1.97, 95% CI 1.35–2.89, P = 0.0004, respectively). In conclusion, these data suggest a dissociation of graft-versus-leukemia effects from GVHD in patients with active AML treated with PTCy-based Haplo-HCT.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1