Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia

Matthew J. Wieduwilt; Leland Metheny; Mei Jie Zhang; Hai Lin Wang; Noel Estrada-Merly; David I. Marks; A. Samer Al-Homsi; Lori Muffly; Nelson Chao; David Rizzieri; Robert Peter Gale; Shahinaz M. Gadalla; Mitchell Cairo; Alberto Mussetti; Steven Gore; Vijaya Raj Bhatt; Sagar S. Patel; Fotios V. Michelis; Yoshihiro Inamoto; Sherif M. Badawy; Edward Copelan; Neil Palmisiano; Mohamed A. Kharfan-Dabaja; Hillard M. Lazarus; Siddhartha Ganguly; Christopher Bredeson; Miguel Angel Diaz Perez; Ryan Cassaday; Bipin N. Savani; Karen Ballen; Rodrigo Martino; Baldeep Wirk; Ulrike Bacher; Mahmoud Aljurf; Asad Bashey; Hemant S. Murthy; Jean A. Yared; Ibrahim Aldoss; Nosha Farhadfar; Hongtao Liu; Hisham Abdel-Azim; Edmund K. Waller; Melhem Solh; Matthew D. Seftel; Marjolein van der Poel; Michael R. Grunwald; Jane L. Liesveld; Rammurti T. Kamble; Joseph McGuirk; Reinhold Munker; Jean Yves Cahn; Jong Wook Lee; Cesar O. Freytes; Maxwell M. Krem; Lena E. Winestone; Usama Gergis; Sunita Nathan; Richard F. Olsson; Leo F. Verdonck; Akshay Sharma; Olle Ringden; Brian D. Friend; Jan Cerny; Hannah Choe; Saurabh Chhabra; Taiga Nishihori; Sachiko Seo; Biju George; Lee Ann Baxter-Lowe; Gerhard C. Hildebrandt; Marcos de Lima; Mark Litzow; Partow Kebriaei; Christopher S. Hourigan; Muhammad Bilal Abid; Daniel J. Weisdorf; Wael Saber

doi:10.1182/bloodadvances.2021004916

Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia

Matthew J. Wieduwilt, Leland Metheny, Mei Jie Zhang, Hai Lin Wang, Noel Estrada-Merly, David I. Marks, A. Samer Al-Homsi, Lori Muffly, Nelson Chao, David Rizzieri, Robert Peter Gale, Shahinaz M. Gadalla, Mitchell Cairo, Alberto Mussetti, Steven Gore, Vijaya Raj Bhatt, Sagar S. Patel, Fotios V. Michelis, Yoshihiro Inamoto, Sherif M. BadawyEdward Copelan, Neil Palmisiano, Mohamed A. Kharfan-Dabaja, Hillard M. Lazarus, Siddhartha Ganguly, Christopher Bredeson, Miguel Angel Diaz Perez, Ryan Cassaday, Bipin N. Savani, Karen Ballen, Rodrigo Martino, Baldeep Wirk, Ulrike Bacher, Mahmoud Aljurf, Asad Bashey, Hemant S. Murthy, Jean A. Yared, Ibrahim Aldoss, Nosha Farhadfar, Hongtao Liu, Hisham Abdel-Azim, Edmund K. Waller, Melhem Solh, Matthew D. Seftel, Marjolein van der Poel, Michael R. Grunwald, Jane L. Liesveld, Rammurti T. Kamble, Joseph McGuirk, Reinhold Munker, Jean Yves Cahn, Jong Wook Lee, Cesar O. Freytes, Maxwell M. Krem, Lena E. Winestone, Usama Gergis, Sunita Nathan, Richard F. Olsson, Leo F. Verdonck, Akshay Sharma, Olle Ringden, Brian D. Friend, Jan Cerny, Hannah Choe, Saurabh Chhabra, Taiga Nishihori, Sachiko Seo, Biju George, Lee Ann Baxter-Lowe, Gerhard C. Hildebrandt, Marcos de Lima, Mark Litzow, Partow Kebriaei, Christopher S. Hourigan, Muhammad Bilal Abid, Daniel J. Weisdorf, Wael Saber

Research output: Contribution to journal › Article › peer-review

38 Scopus citations

Abstract

The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

Original language	English (US)
Pages (from-to)	339-357
Number of pages	19
Journal	Blood Advances
Volume	6
Issue number	1
DOIs	https://doi.org/10.1182/bloodadvances.2021004916
State	Published - Jan 11 2022

Keywords

Fetal Blood
Hematopoietic Stem Cell Transplantation/adverse effects
Humans
Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy
Retrospective Studies
Siblings
Unrelated Donors

PubMed: MeSH publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Journal Article
Research Support, N.I.H., Extramural

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1182/bloodadvances.2021004916

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Wieduwilt, M. J., Metheny, L., Zhang, M. J., Wang, H. L., Estrada-Merly, N., Marks, D. I., Samer Al-Homsi, A., Muffly, L., Chao, N., Rizzieri, D., Gale, R. P., Gadalla, S. M., Cairo, M., Mussetti, A., Gore, S., Bhatt, V. R., Patel, S. S., Michelis, F. V., Inamoto, Y., ... Saber, W. (2022). Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia. Blood Advances, 6(1), 339-357. https://doi.org/10.1182/bloodadvances.2021004916

Wieduwilt, MJ, Metheny, L, Zhang, MJ, Wang, HL, Estrada-Merly, N, Marks, DI, Samer Al-Homsi, A, Muffly, L, Chao, N, Rizzieri, D, Gale, RP, Gadalla, SM, Cairo, M, Mussetti, A, Gore, S, Bhatt, VR, Patel, SS, Michelis, FV, Inamoto, Y, Badawy, SM, Copelan, E, Palmisiano, N, Kharfan-Dabaja, MA, Lazarus, HM, Ganguly, S, Bredeson, C, Perez, MAD, Cassaday, R, Savani, BN, Ballen, K, Martino, R, Wirk, B, Bacher, U, Aljurf, M, Bashey, A, Murthy, HS, Yared, JA, Aldoss, I, Farhadfar, N, Liu, H, Abdel-Azim, H, Waller, EK, Solh, M, Seftel, MD, van der Poel, M, Grunwald, MR, Liesveld, JL, Kamble, RT, McGuirk, J, Munker, R, Cahn, JY, Lee, JW, Freytes, CO, Krem, MM, Winestone, LE, Gergis, U, Nathan, S, Olsson, RF, Verdonck, LF, Sharma, A, Ringden, O, Friend, BD, Cerny, J, Choe, H, Chhabra, S, Nishihori, T, Seo, S, George, B, Baxter-Lowe, LA, Hildebrandt, GC, de Lima, M, Litzow, M, Kebriaei, P, Hourigan, CS, Abid, MB, Weisdorf, DJ & Saber, W 2022, 'Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia', Blood Advances, vol. 6, no. 1, pp. 339-357. https://doi.org/10.1182/bloodadvances.2021004916

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title = "Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia",

abstract = "The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.",

keywords = "Fetal Blood, Hematopoietic Stem Cell Transplantation/adverse effects, Humans, Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy, Retrospective Studies, Siblings, Unrelated Donors",

author = "Wieduwilt, {Matthew J.} and Leland Metheny and Zhang, {Mei Jie} and Wang, {Hai Lin} and Noel Estrada-Merly and Marks, {David I.} and {Samer Al-Homsi}, A. and Lori Muffly and Nelson Chao and David Rizzieri and Gale, {Robert Peter} and Gadalla, {Shahinaz M.} and Mitchell Cairo and Alberto Mussetti and Steven Gore and Bhatt, {Vijaya Raj} and Patel, {Sagar S.} and Michelis, {Fotios V.} and Yoshihiro Inamoto and Badawy, {Sherif M.} and Edward Copelan and Neil Palmisiano and Kharfan-Dabaja, {Mohamed A.} and Lazarus, {Hillard M.} and Siddhartha Ganguly and Christopher Bredeson and Perez, {Miguel Angel Diaz} and Ryan Cassaday and Savani, {Bipin N.} and Karen Ballen and Rodrigo Martino and Baldeep Wirk and Ulrike Bacher and Mahmoud Aljurf and Asad Bashey and Murthy, {Hemant S.} and Yared, {Jean A.} and Ibrahim Aldoss and Nosha Farhadfar and Hongtao Liu and Hisham Abdel-Azim and Waller, {Edmund K.} and Melhem Solh and Seftel, {Matthew D.} and {van der Poel}, Marjolein and Grunwald, {Michael R.} and Liesveld, {Jane L.} and Kamble, {Rammurti T.} and Joseph McGuirk and Reinhold Munker and Cahn, {Jean Yves} and Lee, {Jong Wook} and Freytes, {Cesar O.} and Krem, {Maxwell M.} and Winestone, {Lena E.} and Usama Gergis and Sunita Nathan and Olsson, {Richard F.} and Verdonck, {Leo F.} and Akshay Sharma and Olle Ringden and Friend, {Brian D.} and Jan Cerny and Hannah Choe and Saurabh Chhabra and Taiga Nishihori and Sachiko Seo and Biju George and Baxter-Lowe, {Lee Ann} and Hildebrandt, {Gerhard C.} and {de Lima}, Marcos and Mark Litzow and Partow Kebriaei and Hourigan, {Christopher S.} and Abid, {Muhammad Bilal} and Weisdorf, {Daniel J.} and Wael Saber",

year = "2022",

month = jan,

day = "11",

doi = "10.1182/bloodadvances.2021004916",

language = "English (US)",

volume = "6",

pages = "339--357",

journal = "Blood Advances",

issn = "2473-9529",

publisher = "American Society of Hematology",

number = "1",

}

TY - JOUR

T1 - Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia

AU - Wieduwilt, Matthew J.

AU - Metheny, Leland

AU - Zhang, Mei Jie

AU - Wang, Hai Lin

AU - Estrada-Merly, Noel

AU - Marks, David I.

AU - Samer Al-Homsi, A.

AU - Muffly, Lori

AU - Chao, Nelson

AU - Rizzieri, David

AU - Gale, Robert Peter

AU - Gadalla, Shahinaz M.

AU - Cairo, Mitchell

AU - Mussetti, Alberto

AU - Gore, Steven

AU - Bhatt, Vijaya Raj

AU - Patel, Sagar S.

AU - Michelis, Fotios V.

AU - Inamoto, Yoshihiro

AU - Badawy, Sherif M.

AU - Copelan, Edward

AU - Palmisiano, Neil

AU - Kharfan-Dabaja, Mohamed A.

AU - Lazarus, Hillard M.

AU - Ganguly, Siddhartha

AU - Bredeson, Christopher

AU - Perez, Miguel Angel Diaz

AU - Cassaday, Ryan

AU - Savani, Bipin N.

AU - Ballen, Karen

AU - Martino, Rodrigo

AU - Wirk, Baldeep

AU - Bacher, Ulrike

AU - Aljurf, Mahmoud

AU - Bashey, Asad

AU - Murthy, Hemant S.

AU - Yared, Jean A.

AU - Aldoss, Ibrahim

AU - Farhadfar, Nosha

AU - Liu, Hongtao

AU - Abdel-Azim, Hisham

AU - Waller, Edmund K.

AU - Solh, Melhem

AU - Seftel, Matthew D.

AU - van der Poel, Marjolein

AU - Grunwald, Michael R.

AU - Liesveld, Jane L.

AU - Kamble, Rammurti T.

AU - McGuirk, Joseph

AU - Munker, Reinhold

AU - Cahn, Jean Yves

AU - Lee, Jong Wook

AU - Freytes, Cesar O.

AU - Krem, Maxwell M.

AU - Winestone, Lena E.

AU - Gergis, Usama

AU - Nathan, Sunita

AU - Olsson, Richard F.

AU - Verdonck, Leo F.

AU - Sharma, Akshay

AU - Ringden, Olle

AU - Friend, Brian D.

AU - Cerny, Jan

AU - Choe, Hannah

AU - Chhabra, Saurabh

AU - Nishihori, Taiga

AU - Seo, Sachiko

AU - George, Biju

AU - Baxter-Lowe, Lee Ann

AU - Hildebrandt, Gerhard C.

AU - de Lima, Marcos

AU - Litzow, Mark

AU - Kebriaei, Partow

AU - Hourigan, Christopher S.

AU - Abid, Muhammad Bilal

AU - Weisdorf, Daniel J.

AU - Saber, Wael

PY - 2022/1/11

Y1 - 2022/1/11

N2 - The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

AB - The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

KW - Fetal Blood

KW - Hematopoietic Stem Cell Transplantation/adverse effects

KW - Humans

KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy

KW - Retrospective Studies

KW - Siblings

KW - Unrelated Donors

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UR - http://www.scopus.com/inward/citedby.url?scp=85123008568&partnerID=8YFLogxK

U2 - 10.1182/bloodadvances.2021004916

DO - 10.1182/bloodadvances.2021004916

M3 - Article

C2 - 34547770

AN - SCOPUS:85123008568

SN - 2473-9529

VL - 6

SP - 339

EP - 357

JO - Blood Advances

JF - Blood Advances

IS - 1

ER -

Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia

Abstract

Keywords

PubMed: MeSH publication types

UN SDGs

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