Ex vivo T cell-depleted hematopoietic stem cell transplantation for adult patients with acute myelogenous leukemia in first and second remission: Long-term disease-free survival with a significantly reduced risk of graft-versus-host disease Journal Article
| Authors: | Montoro, J.; Ceberio, I.; Hilden, P.; Maloy, M. A.; Barker, J.; Castro-Malaspina, H.; Dahi, P.; Koehne, G.; Perales, M. A.; Ponce, D.; Sauter, C.; Shaffer, B.; Tamari, R.; Young, J. W.; Giralt, S. A.; O'Reilly, R. J.; Jakubowski, A. A.; Papadopoulos, E. B. |
| Article Title: | Ex vivo T cell-depleted hematopoietic stem cell transplantation for adult patients with acute myelogenous leukemia in first and second remission: Long-term disease-free survival with a significantly reduced risk of graft-versus-host disease |
| Abstract: | Large series of patients with acute myelogenous leukemia (AML) after ex vivo T cell-depleted (TCD) allogeneic hematopoietic stem cell transplantation (allo-HSCT) have not been reported previously. We retrospectively analyzed the outcomes of 266 patients (median age, 54 years) with AML who received CD34-selected TCD allo-HSCTs while in first (75%) or second (25%) complete remission (CR1/CR2) at a single institution. The conditioning regimens were all myeloablative, and no additional graft-versus-host disease (GVHD) prophylaxis was given. The cumulative incidences of grade II-IV and grade III-IV acute GVHD at 180 days were 14% (95% confidence interval [CI], 10% to 18%) and 3% (95% CI, 1% to 5%), respectively. The cumulative incidence of chronic GVHD at 3 years was 3% (95% CI, 1% to 6%). The 3-year cumulative incidence of nonrelapse mortality was 21% (95% CI, 16% to 26%) and that of relapse was 21% (95% CI, 17% to 27%). Overall survival (OS) and disease-free survival (DFS) at 1, 3, and 5 years were 75%, 61%, and 56% and 68%, 57%, and 53%, respectively. There were no significant differences in OS, DFS, and relapse rates for patients who underwent transplantation in CR1 and those who did so in CR2. However, patients with high-risk cytogenetics at diagnosis had significantly poorer outcomes. The OS and DFS rates compare favorably with those for unmodified allo-HSCT, but with considerably lower rates of GVHD. © 2019 American Society for Transplantation and Cellular Therapy |
| Keywords: | adult; cancer survival; human cell; major clinical study; overall survival; busulfan; fludarabine; nonhuman; treatment duration; cancer patient; disease free survival; radiation dose; cancer staging; outcome assessment; recurrence risk; cancer incidence; prospective study; cytogenetics; cyclophosphamide; melphalan; stem cell transplantation; hematopoietic stem cell transplantation; retrospective study; thiotepa; acute graft versus host disease; chronic graft versus host disease; engraftment; hla matching; myeloablative conditioning; whole body radiation; peripheral blood stem cell; graft versus host reaction; long term care; single drug dose; allogeneic hematopoietic stem cell transplantation; t cell depletion; gvhd; risk reduction; granulocyte colony stimulating factor; cytomegalovirus infection; leukemia remission; aml; unrelated donor; acute myeloid leukemia; epstein barr virus infection; human; male; female; article; de novo acute myeloid leukemia; secondary acute myeloid leukemia; transplantation outcomes; matched related donor |
| Journal Title: | Biology of Blood and Marrow Transplantation |
| Volume: | 26 |
| Issue: | 2 |
| ISSN: | 1083-8791 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2020-02-01 |
| Start Page: | 323 |
| End Page: | 332 |
| Language: | English |
| DOI: | 10.1016/j.bbmt.2019.10.003 |
| PUBMED: | 31618690 |
| PROVIDER: | scopus |
| PMCID: | PMC8754351 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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