Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission

Armin Rashidi, Mehdi Hamadani, Mei Jie Zhang, Hai Lin Wang, Hisham Abdel-Azim, Mahmoud Aljurf, Amer Assal, Ashish Bajel, Asad Bashey, Minoo Battiwalla, Amer M. Beitinjaneh, Nelli Bejanyan, Vijaya Raj Bhatt, Javier Bolaños-Meade, Michael Byrne, Jean Yves Cahn, Mitchell Cairo, Stefan Ciurea, Edward Copelan, Corey CutlerAndrew Daly, Miguel Angel Diaz, Nosha Farhadfar, Robert P. Gale, Siddhartha Ganguly, Michael R. Grunwald, Theresa Hahn, Shahrukh Hashmi, Gerhard C. Hildebrandt, H. Kent Holland, Nasheed Hossain, Christopher G. Kanakry, Mohamed A. Kharfan-Dabaja, Nandita Khera, Yener Koc, Hillard M. Lazarus, Jong Wook Lee, Johan Maertens, Rodrigo Martino, Joseph McGuirk, Reinhold Munker, Hemant S. Murthy, Ryotaro Nakamura, Sunita Nathan, Taiga Nishihori, Neil Palmisiano, Sagar Patel, Joseph Pidala, Rebecca Olin, Richard F. Olsson, Betul Oran, Olov Ringden, David Rizzieri, Jacob Rowe, Mary Lynn Savoie, Kirk R. Schultz, Sachiko Seo, Brian C. Shaffer, Anurag Singh, Melhem Solh, Keith Stockerl-Goldstein, Leo F. Verdonck, John Wagner, Edmund K. Waller, Marcos De Lima, Brenda M. Sandmaier, Mark Litzow, Dan Weisdorf, Rizwan Romee, Wael Saber

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

HLA-haploidentical hematopoietic cell transplantation (Haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) has improved donor availability. However, a matched sibling donor (MSD) is still considered the optimal donor. Using the Center for International Blood and Marrow Transplant Research database, we compared outcomes after Haplo-HCT vs MSD in patients with acute myeloid leukemia (AML) in first complete remission (CR1). Data from 1205 adult CR1 AML patients (2008-2015) were analyzed. A total of 336 patients underwent PT-Cy–based Haplo-HCT and 869 underwent MSD using calcineurin inhibitor–based graft-versus-host disease (GVHD) prophylaxis. The Haplo-HCT group included more reduced-intensity conditioning (65% vs 30%) and bone marrow grafts (62% vs 7%), consistent with current practice. In multivariable analysis, Haplo-HCT and MSD groups were not different with regard to overall survival (P 5 .15), leukemia-free survival (P 5 .50), nonrelapse mortality (P 5 .16), relapse (P 5 .90), or grade II-IV acute GVHD (P 5 .98). However, the Haplo-HCT group had a significantly lower rate of chronic GVHD (hazard ratio, 0.38; 95% confidence interval, 0.30-0.48; P, .001). Results of subgroup analyses by conditioning intensity and graft source suggested that the reduced incidence of chronic GVHD in Haplo-HCT is not limited to a specific graft source or conditioning intensity. Center effect and minimal residual disease–donor type interaction were not predictors of outcome. Our results indicate a lower rate of chronic GVHD after PT-Cy–based Haplo-HCT vs MSD using calcineurin inhibitor–based GVHD prophylaxis, but similar other outcomes, in patients with AML in CR1. Haplo-HCT is a viable alternative to MSD in these patients.

Original languageEnglish (US)
Pages (from-to)1826-1836
Number of pages11
JournalBlood Advances
Volume3
Issue number12
DOIs
StatePublished - Jan 1 2019

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Cell Transplantation
Acute Myeloid Leukemia
Siblings
Transplantation
Graft vs Host Disease
Tissue Donors
Transplants
Calcineurin
Bone Marrow
Survival
Cyclophosphamide
Leukemia
Databases
Confidence Intervals
Recurrence
Mortality
Incidence

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Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission. / Rashidi, Armin; Hamadani, Mehdi; Zhang, Mei Jie; Wang, Hai Lin; Abdel-Azim, Hisham; Aljurf, Mahmoud; Assal, Amer; Bajel, Ashish; Bashey, Asad; Battiwalla, Minoo; Beitinjaneh, Amer M.; Bejanyan, Nelli; Bhatt, Vijaya Raj; Bolaños-Meade, Javier; Byrne, Michael; Cahn, Jean Yves; Cairo, Mitchell; Ciurea, Stefan; Copelan, Edward; Cutler, Corey; Daly, Andrew; Diaz, Miguel Angel; Farhadfar, Nosha; Gale, Robert P.; Ganguly, Siddhartha; Grunwald, Michael R.; Hahn, Theresa; Hashmi, Shahrukh; Hildebrandt, Gerhard C.; Kent Holland, H.; Hossain, Nasheed; Kanakry, Christopher G.; Kharfan-Dabaja, Mohamed A.; Khera, Nandita; Koc, Yener; Lazarus, Hillard M.; Lee, Jong Wook; Maertens, Johan; Martino, Rodrigo; McGuirk, Joseph; Munker, Reinhold; Murthy, Hemant S.; Nakamura, Ryotaro; Nathan, Sunita; Nishihori, Taiga; Palmisiano, Neil; Patel, Sagar; Pidala, Joseph; Olin, Rebecca; Olsson, Richard F.; Oran, Betul; Ringden, Olov; Rizzieri, David; Rowe, Jacob; Savoie, Mary Lynn; Schultz, Kirk R.; Seo, Sachiko; Shaffer, Brian C.; Singh, Anurag; Solh, Melhem; Stockerl-Goldstein, Keith; Verdonck, Leo F.; Wagner, John; Waller, Edmund K.; De Lima, Marcos; Sandmaier, Brenda M.; Litzow, Mark; Weisdorf, Dan; Romee, Rizwan; Saber, Wael.

In: Blood Advances, Vol. 3, No. 12, 01.01.2019, p. 1826-1836.

Research output: Contribution to journalArticle

Rashidi, A, Hamadani, M, Zhang, MJ, Wang, HL, Abdel-Azim, H, Aljurf, M, Assal, A, Bajel, A, Bashey, A, Battiwalla, M, Beitinjaneh, AM, Bejanyan, N, Bhatt, VR, Bolaños-Meade, J, Byrne, M, Cahn, JY, Cairo, M, Ciurea, S, Copelan, E, Cutler, C, Daly, A, Diaz, MA, Farhadfar, N, Gale, RP, Ganguly, S, Grunwald, MR, Hahn, T, Hashmi, S, Hildebrandt, GC, Kent Holland, H, Hossain, N, Kanakry, CG, Kharfan-Dabaja, MA, Khera, N, Koc, Y, Lazarus, HM, Lee, JW, Maertens, J, Martino, R, McGuirk, J, Munker, R, Murthy, HS, Nakamura, R, Nathan, S, Nishihori, T, Palmisiano, N, Patel, S, Pidala, J, Olin, R, Olsson, RF, Oran, B, Ringden, O, Rizzieri, D, Rowe, J, Savoie, ML, Schultz, KR, Seo, S, Shaffer, BC, Singh, A, Solh, M, Stockerl-Goldstein, K, Verdonck, LF, Wagner, J, Waller, EK, De Lima, M, Sandmaier, BM, Litzow, M, Weisdorf, D, Romee, R & Saber, W 2019, 'Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission', Blood Advances, vol. 3, no. 12, pp. 1826-1836. https://doi.org/10.1182/bloodadvances.2019000050
Rashidi, Armin ; Hamadani, Mehdi ; Zhang, Mei Jie ; Wang, Hai Lin ; Abdel-Azim, Hisham ; Aljurf, Mahmoud ; Assal, Amer ; Bajel, Ashish ; Bashey, Asad ; Battiwalla, Minoo ; Beitinjaneh, Amer M. ; Bejanyan, Nelli ; Bhatt, Vijaya Raj ; Bolaños-Meade, Javier ; Byrne, Michael ; Cahn, Jean Yves ; Cairo, Mitchell ; Ciurea, Stefan ; Copelan, Edward ; Cutler, Corey ; Daly, Andrew ; Diaz, Miguel Angel ; Farhadfar, Nosha ; Gale, Robert P. ; Ganguly, Siddhartha ; Grunwald, Michael R. ; Hahn, Theresa ; Hashmi, Shahrukh ; Hildebrandt, Gerhard C. ; Kent Holland, H. ; Hossain, Nasheed ; Kanakry, Christopher G. ; Kharfan-Dabaja, Mohamed A. ; Khera, Nandita ; Koc, Yener ; Lazarus, Hillard M. ; Lee, Jong Wook ; Maertens, Johan ; Martino, Rodrigo ; McGuirk, Joseph ; Munker, Reinhold ; Murthy, Hemant S. ; Nakamura, Ryotaro ; Nathan, Sunita ; Nishihori, Taiga ; Palmisiano, Neil ; Patel, Sagar ; Pidala, Joseph ; Olin, Rebecca ; Olsson, Richard F. ; Oran, Betul ; Ringden, Olov ; Rizzieri, David ; Rowe, Jacob ; Savoie, Mary Lynn ; Schultz, Kirk R. ; Seo, Sachiko ; Shaffer, Brian C. ; Singh, Anurag ; Solh, Melhem ; Stockerl-Goldstein, Keith ; Verdonck, Leo F. ; Wagner, John ; Waller, Edmund K. ; De Lima, Marcos ; Sandmaier, Brenda M. ; Litzow, Mark ; Weisdorf, Dan ; Romee, Rizwan ; Saber, Wael. / Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission. In: Blood Advances. 2019 ; Vol. 3, No. 12. pp. 1826-1836.
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title = "Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission",
abstract = "HLA-haploidentical hematopoietic cell transplantation (Haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) has improved donor availability. However, a matched sibling donor (MSD) is still considered the optimal donor. Using the Center for International Blood and Marrow Transplant Research database, we compared outcomes after Haplo-HCT vs MSD in patients with acute myeloid leukemia (AML) in first complete remission (CR1). Data from 1205 adult CR1 AML patients (2008-2015) were analyzed. A total of 336 patients underwent PT-Cy–based Haplo-HCT and 869 underwent MSD using calcineurin inhibitor–based graft-versus-host disease (GVHD) prophylaxis. The Haplo-HCT group included more reduced-intensity conditioning (65{\%} vs 30{\%}) and bone marrow grafts (62{\%} vs 7{\%}), consistent with current practice. In multivariable analysis, Haplo-HCT and MSD groups were not different with regard to overall survival (P 5 .15), leukemia-free survival (P 5 .50), nonrelapse mortality (P 5 .16), relapse (P 5 .90), or grade II-IV acute GVHD (P 5 .98). However, the Haplo-HCT group had a significantly lower rate of chronic GVHD (hazard ratio, 0.38; 95{\%} confidence interval, 0.30-0.48; P, .001). Results of subgroup analyses by conditioning intensity and graft source suggested that the reduced incidence of chronic GVHD in Haplo-HCT is not limited to a specific graft source or conditioning intensity. Center effect and minimal residual disease–donor type interaction were not predictors of outcome. Our results indicate a lower rate of chronic GVHD after PT-Cy–based Haplo-HCT vs MSD using calcineurin inhibitor–based GVHD prophylaxis, but similar other outcomes, in patients with AML in CR1. Haplo-HCT is a viable alternative to MSD in these patients.",
author = "Armin Rashidi and Mehdi Hamadani and Zhang, {Mei Jie} and Wang, {Hai Lin} and Hisham Abdel-Azim and Mahmoud Aljurf and Amer Assal and Ashish Bajel and Asad Bashey and Minoo Battiwalla and Beitinjaneh, {Amer M.} and Nelli Bejanyan and Bhatt, {Vijaya Raj} and Javier Bola{\~n}os-Meade and Michael Byrne and Cahn, {Jean Yves} and Mitchell Cairo and Stefan Ciurea and Edward Copelan and Corey Cutler and Andrew Daly and Diaz, {Miguel Angel} and Nosha Farhadfar and Gale, {Robert P.} and Siddhartha Ganguly and Grunwald, {Michael R.} and Theresa Hahn and Shahrukh Hashmi and Hildebrandt, {Gerhard C.} and {Kent Holland}, H. and Nasheed Hossain and Kanakry, {Christopher G.} and Kharfan-Dabaja, {Mohamed A.} and Nandita Khera and Yener Koc and Lazarus, {Hillard M.} and Lee, {Jong Wook} and Johan Maertens and Rodrigo Martino and Joseph McGuirk and Reinhold Munker and Murthy, {Hemant S.} and Ryotaro Nakamura and Sunita Nathan and Taiga Nishihori and Neil Palmisiano and Sagar Patel and Joseph Pidala and Rebecca Olin and Olsson, {Richard F.} and Betul Oran and Olov Ringden and David Rizzieri and Jacob Rowe and Savoie, {Mary Lynn} and Schultz, {Kirk R.} and Sachiko Seo and Shaffer, {Brian C.} and Anurag Singh and Melhem Solh and Keith Stockerl-Goldstein and Verdonck, {Leo F.} and John Wagner and Waller, {Edmund K.} and {De Lima}, Marcos and Sandmaier, {Brenda M.} and Mark Litzow and Dan Weisdorf and Rizwan Romee and Wael Saber",
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month = "1",
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TY - JOUR

T1 - Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission

AU - Rashidi, Armin

AU - Hamadani, Mehdi

AU - Zhang, Mei Jie

AU - Wang, Hai Lin

AU - Abdel-Azim, Hisham

AU - Aljurf, Mahmoud

AU - Assal, Amer

AU - Bajel, Ashish

AU - Bashey, Asad

AU - Battiwalla, Minoo

AU - Beitinjaneh, Amer M.

AU - Bejanyan, Nelli

AU - Bhatt, Vijaya Raj

AU - Bolaños-Meade, Javier

AU - Byrne, Michael

AU - Cahn, Jean Yves

AU - Cairo, Mitchell

AU - Ciurea, Stefan

AU - Copelan, Edward

AU - Cutler, Corey

AU - Daly, Andrew

AU - Diaz, Miguel Angel

AU - Farhadfar, Nosha

AU - Gale, Robert P.

AU - Ganguly, Siddhartha

AU - Grunwald, Michael R.

AU - Hahn, Theresa

AU - Hashmi, Shahrukh

AU - Hildebrandt, Gerhard C.

AU - Kent Holland, H.

AU - Hossain, Nasheed

AU - Kanakry, Christopher G.

AU - Kharfan-Dabaja, Mohamed A.

AU - Khera, Nandita

AU - Koc, Yener

AU - Lazarus, Hillard M.

AU - Lee, Jong Wook

AU - Maertens, Johan

AU - Martino, Rodrigo

AU - McGuirk, Joseph

AU - Munker, Reinhold

AU - Murthy, Hemant S.

AU - Nakamura, Ryotaro

AU - Nathan, Sunita

AU - Nishihori, Taiga

AU - Palmisiano, Neil

AU - Patel, Sagar

AU - Pidala, Joseph

AU - Olin, Rebecca

AU - Olsson, Richard F.

AU - Oran, Betul

AU - Ringden, Olov

AU - Rizzieri, David

AU - Rowe, Jacob

AU - Savoie, Mary Lynn

AU - Schultz, Kirk R.

AU - Seo, Sachiko

AU - Shaffer, Brian C.

AU - Singh, Anurag

AU - Solh, Melhem

AU - Stockerl-Goldstein, Keith

AU - Verdonck, Leo F.

AU - Wagner, John

AU - Waller, Edmund K.

AU - De Lima, Marcos

AU - Sandmaier, Brenda M.

AU - Litzow, Mark

AU - Weisdorf, Dan

AU - Romee, Rizwan

AU - Saber, Wael

PY - 2019/1/1

Y1 - 2019/1/1

N2 - HLA-haploidentical hematopoietic cell transplantation (Haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) has improved donor availability. However, a matched sibling donor (MSD) is still considered the optimal donor. Using the Center for International Blood and Marrow Transplant Research database, we compared outcomes after Haplo-HCT vs MSD in patients with acute myeloid leukemia (AML) in first complete remission (CR1). Data from 1205 adult CR1 AML patients (2008-2015) were analyzed. A total of 336 patients underwent PT-Cy–based Haplo-HCT and 869 underwent MSD using calcineurin inhibitor–based graft-versus-host disease (GVHD) prophylaxis. The Haplo-HCT group included more reduced-intensity conditioning (65% vs 30%) and bone marrow grafts (62% vs 7%), consistent with current practice. In multivariable analysis, Haplo-HCT and MSD groups were not different with regard to overall survival (P 5 .15), leukemia-free survival (P 5 .50), nonrelapse mortality (P 5 .16), relapse (P 5 .90), or grade II-IV acute GVHD (P 5 .98). However, the Haplo-HCT group had a significantly lower rate of chronic GVHD (hazard ratio, 0.38; 95% confidence interval, 0.30-0.48; P, .001). Results of subgroup analyses by conditioning intensity and graft source suggested that the reduced incidence of chronic GVHD in Haplo-HCT is not limited to a specific graft source or conditioning intensity. Center effect and minimal residual disease–donor type interaction were not predictors of outcome. Our results indicate a lower rate of chronic GVHD after PT-Cy–based Haplo-HCT vs MSD using calcineurin inhibitor–based GVHD prophylaxis, but similar other outcomes, in patients with AML in CR1. Haplo-HCT is a viable alternative to MSD in these patients.

AB - HLA-haploidentical hematopoietic cell transplantation (Haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) has improved donor availability. However, a matched sibling donor (MSD) is still considered the optimal donor. Using the Center for International Blood and Marrow Transplant Research database, we compared outcomes after Haplo-HCT vs MSD in patients with acute myeloid leukemia (AML) in first complete remission (CR1). Data from 1205 adult CR1 AML patients (2008-2015) were analyzed. A total of 336 patients underwent PT-Cy–based Haplo-HCT and 869 underwent MSD using calcineurin inhibitor–based graft-versus-host disease (GVHD) prophylaxis. The Haplo-HCT group included more reduced-intensity conditioning (65% vs 30%) and bone marrow grafts (62% vs 7%), consistent with current practice. In multivariable analysis, Haplo-HCT and MSD groups were not different with regard to overall survival (P 5 .15), leukemia-free survival (P 5 .50), nonrelapse mortality (P 5 .16), relapse (P 5 .90), or grade II-IV acute GVHD (P 5 .98). However, the Haplo-HCT group had a significantly lower rate of chronic GVHD (hazard ratio, 0.38; 95% confidence interval, 0.30-0.48; P, .001). Results of subgroup analyses by conditioning intensity and graft source suggested that the reduced incidence of chronic GVHD in Haplo-HCT is not limited to a specific graft source or conditioning intensity. Center effect and minimal residual disease–donor type interaction were not predictors of outcome. Our results indicate a lower rate of chronic GVHD after PT-Cy–based Haplo-HCT vs MSD using calcineurin inhibitor–based GVHD prophylaxis, but similar other outcomes, in patients with AML in CR1. Haplo-HCT is a viable alternative to MSD in these patients.

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