Reduced-intensity transplantation for lymphomas using haploidentical related donors vs HLA-matched unrelated donors Journal Article


Authors: Kanate, A. S.; Mussetti, A.; Kharfan-Dabaja, M. A.; Ahn, K. W.; DiGilio, A.; Beitinjaneh, A.; Chhabra, S.; Fenske, T. S.; Freytes, C.; Gale, R. P.; Ganguly, S.; Hertzberg, M.; Klyuchnikov, E.; Lazarus, H. M.; Olsson, R.; Perales, M. A.; Rezvani, A.; Riches, M.; Saad, A.; Slavin, S.; Smith, S. M.; Sureda, A.; Yared, J.; Ciurea, S.; Armand, P.; Salit, R.; Bolaños-Meade, J.; Hamadani, M.
Article Title: Reduced-intensity transplantation for lymphomas using haploidentical related donors vs HLA-matched unrelated donors
Abstract: We evaluated 917 adult lymphoma patients who received haploidentical (n 5 185) or HLAmatched unrelated donor (URD) transplantation either with (n 5 241) or without antithymocyte globulin (ATG; n 5 491) following reduced-intensity conditioning regimens. Haploidentical recipients received posttransplant cyclophosphamide-based graft-versushost disease (GVHD) prophylaxis, whereas URD recipients received calcineurin inhibitorbased prophylaxis. Median follow-up of survivors was 3 years. The 100-day cumulative incidence of grade III-IV acute GVHD on univariate analysis was 8%, 12%, and 17% in the haploidentical, URD without ATG, and URD with ATG groups, respectively (P 5 .44). Corresponding 1-year rates of chronic GVHD on univariate analysis were 13%, 51%, and 33%, respectively (P < .001).Onmultivariate analysis, grade III-IV acuteGVHDwas higher in URD without ATG (P 5 .001), as well as URD with ATG (P 5 .01), relative to haploidentical transplants. Similarly, relative to haploidentical transplants, risk of chronic GVHD was higher in URDwithout ATGandURD withATG(P < .0001). Cumulative incidence of relapse/ progression at 3 years was 36%, 28%, and 36%in the haploidentical,URDwithout ATG, and URD with ATG groups, respectively (P 5 .07). Corresponding 3-year overall survival (OS) was 60%, 62%, and 50% in the 3 groups, respectively, withmultivariate analysis showing no survival difference between URD without ATG (P 5 .21) or URD with ATG (P 5 .16), relative to haploidentical transplants.Multivariate analysis showed no difference between the 3 groups in terms of nonrelapsemortality (NRM), relapse/progression, and progression-free survival (PFS). These data suggest that reduced-intensity conditioning haploidentical transplantation with posttransplant cyclophosphamide does not compromise early survival outcomes compared with matched URD transplantation, and is associated with significantly reduced risk of chronic GVHD. (Blood. 2016;127(7):938-947). © 2016 by The American Society of Hematology.
Journal Title: Blood
Volume: 127
Issue: 7
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2016-02-18
Start Page: 938
End Page: 947
Language: English
DOI: 10.1182/blood-2015-09-671834
PROVIDER: scopus
PMCID: PMC4760094
PUBMED: 26670632
DOI/URL:
Notes: Article -- Export Date: 4 April 2016 -- Source: Scopus
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MSK Authors
  1. Miguel-Angel Perales
    405 Perales