Three-Year Outcomes in Recipients of Mismatched Unrelated Bone Marrow Donor Transplants Using Post-Transplantation Cyclophosphamide: Follow-Up from a National Marrow Donor Program-Sponsored Prospective Clinical Trial

被引：17

作者：

Shaw, Bronwen E. ^{[1
]}

Jimenez-Jimenez, Antonio Martin ^{[2
]}

Burns, Linda J. ^{[3
]}

Logan, Brent R. ^{[1
,4
]}

Khimani, Farhad ^{[5
]}

Shaffer, Brian C. ^{[6
]}

Shah, Nirav N. ^{[7
]}

Mussetter, Alisha ^{[8
]}

Tang, Xiao-Ying ^{[1
]}

McCarty, John M. ^{[9
]}

Alavi, Asif ^{[10
]}

Farhadfar, Nosha ^{[11
]}

Jamieson, Katarzyna ^{[12
]}

Hardy, Nancy M. ^{[13
]}

Choe, Hannah ^{[14
]}

Ambinder, Richard F. ^{[15
]}

Anasetti, Claudio ^{[5
]}

Perales, Miguel -Angel ^{[6
]}

Spellman, Stephen R. ^{[8
]}

Howard, Alan ^{[8
]}

V. Komanduri, Krishna ^{[16
]}

Luznik, Leo ^{[15
]}

Norkin, Maxim ^{[17
]}

Pidala, Joseph A. ^{[5
]}

Ratanantharathorn, Voravit ^{[10
]}

Confer, Dennis L. ^{[8
]}

Devine, Steven M. ^{[8
]}

Horowitz, Mary M. ^{[1
]}

Bolanos-Meade, Javier ^{[15
]}

机构：

[1] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Dept Med, Milwaukee, WI USA

[2] Univ Miami, Miller Sch Med, Div Transplantat & Cellular Therapy, Miami, FL USA

[3] Med Coll Wisconsin, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI USA

[4] Med Coll Wisconsin, Inst Hlth & Equ, Div Biostat, Milwaukee, WI USA

[5] H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplant & Cellular Immunot, Tampa, FL USA

[6] Mem Sloan Kettering Canc Ctr, Dept Med, Adult Bone Marrow Transplant Serv, New York, NY USA

[7] Med Coll Wisconsin, Dept Med, Milwaukee, WI USA

[8] Natl Marrow Donor Program Be Match, Ctr Int Blood & Marrow Transplant Res, Minneapolis, MN USA

[9] Virginia Commonwealth Univ, Dept Internal Med, Cellular Immunotherapies & Transplant Program, Richmond, VA USA

[10] Wayne State Univ, Karmanos Canc Inst, Dept Oncol, Detroit, MI USA

[11] Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA

[12] Univ North Carolina Hosp Chapel Hill, Chapel Hill, NC USA

[13] Univ Maryland, Greenebaum Canc Ctr, Baltimore, MD USA

[14] Ohio State Univ, Wexner Med Ctr, Comprehens Canc Ctr, Columbus, OH USA

[15] Sidney Kimmel Comprehens Canc Ctr Johns Hopkins, Baltimore, MD USA

[16] Univ Calif San Francisco, UCSF Hlth & Helen Diller Family Comprehens Canc C, Div Hematol & Oncol, San Francisco, CA USA

[17] Baptist MD Anderson Canc Ctr, Jacksonville, FL USA

来源：

TRANSPLANTATION AND CELLULAR THERAPY | 2023年 / 29卷 / 03期

关键词：

Mismatched unrelated donor; Post transplant cyclophosphamide; Hematopoietic cell transplant; HLA;

D O I：

10.1016/j.jtct.2022.12.017

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The use of post-transplantation cyclophosphamide (PTCy) as graft-versus-host disease (GVHD) prophylaxis has resulted in reductions in GVHD and improved outcomes in allogeneic hematopoietic cell transplantation (HCT) using HLA-mismatched related donors. We report the 3-year outcomes of the first multicenter prospective clinical trial using PTCy in the setting of mismatched unrelated donor (MMUD) bone marrow HCT. The study enrolled 80 patients, treated with either myeloablative conditioning (MAC; n = 40) or reducedintensity conditioning (RIC; n = 40), with the primary endpoint of 1-year overall survival (OS). The median follow- up for this study was 34 months (range, 12 to 46 months) in the RIC group and 36 months (range, 18 to 49 months) in the MAC group. Three-year OS and nonrelapse mortality were 70% and 15%, respectively, in the RIC group and 62% and 10% in the MAC group. No GVHD was reported after 1 year. The incidence of relapse was 29% in the RIC group and 51% in the MAC group. OS did not differ based on HLA match grade (63% in the 7/ 8 strata and 71% in the 4 to 6/8 strata). These encouraging outcomes, which were sustained for 3 years post-HCT, support the continued exploration of MMUD HCT using a PTCy plat-form. Important future areas to address include relapse reduction and furthering our understanding of optimal donor selection based on HLA and non-HLA factors.

引用

页码：208e1 / 208e6

页数：6

共 19 条

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