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Author Notes:

Corresponding author: Mehdi Hamadani, MD, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, 9200 W Wisconsin Ave, Suite C5500, Milwaukee, WI 53226; e-mail: mhamadani@mcw.edu.

Conception and design: Nilanjan Ghosh, Reem Karmali, Vanderson Rocha, Mehdi Hamadani Collection and assembly of data: Nilanjan Ghosh, Reem Karmali, Vanderson Rocha, Kwang Woo Ahn, Alyssa DiGilio, Mehdi Hamadani Data analysis and interpretation: All authors Manuscript writing: All authors Final approval of manuscript: All authors

We thank Morgan Geronime for administrative support and Mary Eapen for her valuable scientific input.

See publication for full list of disclosures.

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Research Funding:

The Center for International Blood and Marrow Transplant Research is supported by Public Health Service Grant/Cooperative Agreement U24-CA076518 from the National Cancer Institute, the National Heart, Lung, and Blood Institute, and the National Institute of Allergy and Infectious Diseases; Grant/Cooperative Agreement 5U10HL069294 from the National Heart, Lung, and Blood Institute and National Cancer Institute; contract HHSH250201200016C with Health Resources and Services Administration; two grants, N00014-13-1-0039 and N00014-14-1-0028, from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Allos Therapeutics, *Amgen, Anonymous donation to the Medical College of Wisconsin, Ariad, Be the Match Foundation, *Blue Cross and Blue Shield Association, *Celgene Corporation, Chimerix, Inc, Fred Hutchinson Cancer Research Center, Fresenius-Biotech North America, *Gamida Cell Teva Joint Venture, Genentech,*Gentium SpA, Genzyme Corporation, GlaxoSmithKline, Health Research, Roswell Park Cancer Institute, HistoGenetics, Incyte Corporation, Jeff Gordon Children’s Foundation, Kiadis Pharma, The Leukemia & Lymphoma Society, Medac, The Medical College of Wisconsin, Merck & Co, Millennium: Takeda Oncology, *Milliman USA, *Miltenyi Biotec, National Marrow Donor Program, Onyx Pharmaceuticals, Optum Healthcare Solutions, Osiris Therapeutics, Otsuka America Pharmaceutical, Perkin Elmer, *Remedy Informatics, *Sanofi US, Seattle Genetics, Sigma-Tau Pharmaceuticals, Soligenix, St. Baldrick’s Foundation, StemCyte, A Global Cord Blood Therapeutics, Stemsoft Software, Swedish Orphan Biovitrum, *Tarix Pharmaceuticals, *TerumoBCT, *Teva Neuroscience, *THERAKOS, University of Minnesota, University of Utah, and *Wellpoint.

Asterisks denote corporate members.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • STEM-CELL TRANSPLANTATION
  • UMBILICAL-CORD BLOOD
  • DOSE POSTTRANSPLANTATION CYCLOPHOSPHAMIDE
  • DISEASE RISK INDEX
  • BONE-MARROW
  • UNRELATED DONORS
  • IDENTICAL SIBLINGS
  • ALLOGENEIC TRANSPLANTATION
  • HODGKINS-LYMPHOMA
  • PERIPHERAL-BLOOD

Reduced-Intensity Transplantation for Lymphomas Using Haploidentical Related Donors Versus HLA-Matched Sibling Donors: A Center for International Blood and Marrow Transplant Research Analysis

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Journal Title:

Journal of Clinical Oncology

Volume:

Volume 34, Number 26

Publisher:

, Pages 3141-3149

Type of Work:

Article | Final Publisher PDF

Abstract:

Purpose: Related donor haploidentical hematopoietic cell transplantation (Haplo-HCT) using post-transplantation cyclophosphamide (PT-Cy) is increasingly used in patients lacking HLA-matched sibling donors (MSD). We compared outcomes after Haplo-HCT using PT-Cy with MSD-HCT in patients with lymphoma, using the Center for International Blood and Marrow Transplant Research registry. Materials and Methods: We evaluated 987 adult patients undergoing either Haplo-HCT (n = 180) or MSD-HCT (n = 807) following reduced-intensity conditioning regimens. The haploidentical group received graft-versushost disease (GVHD) prophylaxis with PT-Cy with or without a calcineurin inhibitor and mycophenolate. The MSD group received calcineurin inhibitor-based GVHD prophylaxis. Results: Median follow-up of survivors was 3 years. The 28-day neutrophil recovery was similar in the two groups (95% v 97%; P = .31). The 28-day platelet recovery was delayed in the haploidentical group compared with the MSD group (63% v 91%; P = .001). Cumulative incidence of grade II to IV acute GVHD at day 100 was similar between the two groups (27% v 25%; P = .84). Cumulative incidence of chronic GVHD at 1 year was significantly lower after Haplo-HCT (12% v 45%; P < .001), and this benefit was confirmed on multivariate analysis (relative risk, 0.21; 95% CI, 0.14 to 0.31; P < .001). For Haplo-HCT v MSD-HCT, 3-year rates of nonrelapse mortality (15% v 13%; P = .41), relapse/progression (37% v 40%; P = .51), progression-free survival (48% v 48%; P = .96), and overall survival (61% v 62%; P = .82) were similar. Multivariate analysis showed no significant difference between Haplo-HCT and MSD-HCT in terms of nonrelapse mortality (P = .06), progression/relapse (P = .10), progression-free survival (P = .83), and overall survival (P = .34). Conclusion: Haplo-HCT with PT-Cy provides survival outcomes comparable to MSD-HCT, with a significantly lower risk of chronic GVHD.

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© 2016 by American Society of Clinical Oncology.

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