title: T-replete haploidentical allogeneic transplantation using post-transplantation cyclophosphamide in advanced AML and myelodysplastic syndromes.
abstract: Unmanipulated haploidentical transplantation (Haplo-SCT) using post-transplantation cyclophosphamide (PT-Cy) represents an alternative for patients with high-risk diseases lacking HLA-identical donor. Although it provides low incidences of GVHD, the efficacy of Haplo-SCT is still questioned, especially for patients with myeloid malignancies. Thus, we analyzed 60 consecutive patients with refractory (n=30) or high-risk CR (n=30) AML or myelodysplastic syndromes (MDSs) who underwent PT-Cy Haplo-SCT. The median age was 57 years (22-73 years), hematopoietic cell transplantation comorbidity index was ⩾3 in 38 patients (63%) and Haplo-SCT was the second allogeneic transplantation for 10 patients (17%). Although most of patients received PBSC as graft source (n=48, 80%), we found low incidences of grade 3-4 acute (2%) and severe chronic GVHD (4%). Among patients with high-risk CR diseases, 1-year non-relapse mortality, cumulative incidence of relapse, progression-free and overall survivals were 20%, 32%, 47% and 62%, respectively. In patients with refractory disease, corresponding results were 34%, 35%, 32% and 37%, respectively. We conclude that PT-Cy Haplo-SCT could provide promising anti-leukemic effect even in the setting of very advanced diseases. Thus, it represents a viable alternative for high-risk AML/MDS patients without HLA-identical donor.
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.|Aix-Marseille University, Medicine Faculty, Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Devillier
authors.affiliation: Department of Hematology, Humanitas Cancer Center, Rozzano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bramanti
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Fürst
authors.affiliation: Department of Hematology, Humanitas Cancer Center, Rozzano, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Sarina
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: El-Cheikh
authors.affiliation: Department of Hematology, Humanitas Cancer Center, Rozzano, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Crocchiolo
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Granata
authors.affiliation: Aix-Marseille University, Medicine Faculty, Marseille, France.|Cell Therapy Facility, Institut Paoli Calmettes, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Chabannon
authors.affiliation: Department of Hematology, Humanitas Cancer Center, Rozzano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Morabito
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Harbi
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Faucher
authors.affiliation: Department of Hematology, Humanitas Cancer Center, Rozzano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Santoro
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.|Aix-Marseille University, Medicine Faculty, Marseille, France.
authors.forename: P-J
authors.initials: PJ
authors.lastname: Weiller
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.|Aix-Marseille University, Medicine Faculty, Marseille, France.
authors.forename: N
authors.initials: N
authors.lastname: Vey
authors.affiliation: Department of Hematology, Humanitas Cancer Center, Rozzano, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Carlo-Stella
authors.affiliation: Department of Hematology, Humanitas Cancer Center, Rozzano, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Castagna
authors.affiliation: Department of Hematology, Institut Paoli Calmettes, Marseille, France.|Aix-Marseille University, Medicine Faculty, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Blaise
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D064591:Allografts; D002908:Chronic Disease; D003520:Cyclophosphamide / Q000008:administration & dosage*; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000628:therapy*; D033581:Stem Cell Transplantation
chemical_list: D003520:Cyclophosphamide