title: A survey on unmanipulated haploidentical hematopoietic stem cell transplantation in adults with acute leukemia.
abstract: The use of unmanipulated graft is increasingly adopted in the setting of allogeneic hematopoietic stem cell transplantation from haploidentical family donors (haplo-SCT) in acute leukemia (AL). We analyzed the outcome of 229 adult patients with de novo AL, who received an unmanipulated haploidentical transplant as their first allo-SCT between 2007 and 2011. Median follow-up was 30 months. Disease status at transplant was: first complete remission (CR1) for 77, second CR (CR2) for 56, and advanced for 96 patients. One hundred and seventy-one patients received in vivo T-cell depletion by monoclonal antibodies (75%). The 60-day cumulative incidence (CI) of engraftment was 93±2%. The 100-day CI of acute graft-versus-host disease (GvHD) was 32±3% for grade II-IV, 12±3% for grade III-IV. The 3-year CI of chronic GvHD was 34±3%. The 3-year CI of non-relapse mortality was 31±4% with in vivo T-cell depletion and 17±5% without. At 3 years, for patients transplanted in CR1, CR2 or advanced disease leukemia-free survival was 44±6, 42±7 and 12±3%, overall survival was 55±6, 51±7 and 14±4% and CI of relapse was 32±6, 24±6 and 61±5%, respectively. These data suggest that unmanipulated haplo-SCT is a valid treatment option for adult AL patients in complete remission lacking a matched donor.
authors.affiliation: 1] Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy [2] EBMT Paris Office, Hosital Saint Antoine, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Piemontese
authors.affiliation: 1] Hematology and Bone Marrow Transplant Unit, San Raffaele Scientific Institute, Milan, Italy [2] EBMT Paris Office, Hosital Saint Antoine, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Ciceri
authors.affiliation: 1] EBMT Paris Office, Hosital Saint Antoine, Paris, France [2] AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France [3] Sorbonne Niversité, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France [4] INSERM, MR_S 938, CDR Saint-Antoine, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Division of Hematology II, IRCCS, San Martino University Hospital-IST, Genoa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bacigalupo
authors.affiliation: Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: H
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Hematology, Ospedale Civile, Pescara, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Santarone
authors.affiliation: 1] EBMT Paris Office, Hosital Saint Antoine, Paris, France [2] AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France [3] Sorbonne Niversité, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France [4] INSERM, MR_S 938, CDR Saint-Antoine, Paris, France.
authors.forename: N-C
authors.initials: NC
authors.lastname: Gorin
authors.affiliation: Hematopoietic Stem Cell Transplantation Unit, Medical Park Hospital, Antalya, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Koc
authors.affiliation: The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou, China.
authors.forename: D
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Bone Marrow Transplantation, University Hospital, Essen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Beelen
authors.affiliation: University Hospital of Munich-Klinikum Grosshadern (LMU), Department of Internal Medicine III, Hematopoietic Cell Transplantation, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Tischer
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitaetsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Ehninger
authors.affiliation: Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy.
authors.forename: W
authors.initials: W
authors.lastname: Arcese
authors.affiliation: 1] EBMT Paris Office, Hosital Saint Antoine, Paris, France [2] Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.affiliation: 1] EBMT Paris Office, Hosital Saint Antoine, Paris, France [2] AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France [3] Sorbonne Niversité, UPMC Univ Paris 06, UMR_S 938, CDR Saint-Antoine, Paris, France [4] INSERM, MR_S 938, CDR Saint-Antoine, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D000911:Antibodies, Monoclonal / Q000276:immunology; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006650:Histocompatibility Testing; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000378:metabolism / Q000628:therapy*; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000378:metabolism / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D033581:Stem Cell Transplantation; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal