title: Haploidentical Transplantation with Post-Transplantation Cyclophosphamide for High-Risk Acute Lymphoblastic Leukemia.
abstract: Haploidentical transplantation performed with post-transplantation cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis has been associated with favorable outcomes for patients with acute myeloid leukemia and lymphomas. However, it remains unclear if such approach is effective for patients with acute lymphoblastic leukemia (ALL). We analyzed outcomes of 109 consecutively treated ALL patients 18 years of age and older at 5 institutions. The median age was 32 years and the median follow-up for survivors was 13 months. Thirty-two patients were in first complete remission (CR1), while the rest were beyond CR1. Neutrophil engraftment occurred in 95% of the patients. The cumulative incidences of grades II to IV and III and IV acute GVHD at day 100 after transplantation were 32% and 11%, respectively, whereas chronic GVHD, nonrelapse mortality, relapse rate, and disease-free survival (DFS) at 1 year after transplantation were 32%, 21%, 27%, and 51%, respectively. Patients in CR1 had 52% DFS at 3 years. These results suggest that haploidentical transplants performed with PTCy-based GVHD prophylaxis provide a very suitable alternative to HLA-matched transplantations for patients with ALL.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: Samer A
authors.initials: SA
authors.lastname: Srour
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Denái R
authors.initials: DR
authors.lastname: Milton
authors.affiliation: BMT and Acute Leukemia Program at Northside Hospital, Blood and Marrow Transplant Group of Georgia, Atlanta, Georgia.
authors.forename: Asad
authors.initials: A
authors.lastname: Bashey
authors.affiliation: Bone Marrow Transplant Program, Instituto de Cancerologia-Clinica Las Americas, Medellin, Colombia.
authors.forename: Amado
authors.initials: A
authors.lastname: Karduss-Urueta
authors.affiliation: Department of Hematology and HCT, City of Hope National Medical Center, Duarte, California.
authors.forename: Monzr M
authors.initials: MM
authors.lastname: Al Malki
authors.affiliation: Division of Oncology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Rizwan
authors.initials: R
authors.lastname: Romee
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Scott
authors.initials: S
authors.lastname: Solomon
authors.affiliation: Department of Hematology and HCT, City of Hope National Medical Center, Duarte, California.
authors.forename: Auayporn
authors.initials: A
authors.lastname: Nademanee
authors.affiliation: BMT and Acute Leukemia Program at Northside Hospital, Blood and Marrow Transplant Group of Georgia, Atlanta, Georgia.
authors.forename: Stacey
authors.initials: S
authors.lastname: Brown
authors.affiliation: Division of Oncology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Michael
authors.initials: M
authors.lastname: Slade
authors.affiliation: Bone Marrow Transplant Program, Instituto de Cancerologia-Clinica Las Americas, Medellin, Colombia.
authors.forename: Rosendo
authors.initials: R
authors.lastname: Perez
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rondon
authors.affiliation: Department of Hematology and HCT, City of Hope National Medical Center, Duarte, California.
authors.forename: Stephan J
authors.initials: SJ
authors.lastname: Forman
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Partow
authors.initials: P
authors.lastname: Kebriaei
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: sciurea@mdanderson.org.
authors.forename: Stefan O
authors.initials: SO
authors.lastname: Ciurea
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D003520:Cyclophosphamide / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004341:Drug Evaluation; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D012189:Retrospective Studies; D012306:Risk; D019172:Transplantation Conditioning; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide
keywords: Acute lymphoblastic leukemia; Haploidentical transplantation