Busulfan or Treosulfan Conditioning Platform for Allogeneic Stem Cell Transplantation in Patients Aged >60 Y With Acute Myeloid Leukemia/Myelodysplastic Syndrome: A Subanalysis of the GITMO AlloEld Study-Reference-Cited by-同舟云学术

Busulfan or Treosulfan Conditioning Platform for Allogeneic Stem Cell Transplantation in Patients Aged >60 Y With Acute Myeloid Leukemia/Myelodysplastic Syndrome: A Subanalysis of the GITMO AlloEld Study

Published:2023-02-22 Issue:3 Volume:9 Page:e1451
ISSN:2373-8731
Container-title:Transplantation Direct
language:en
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Author:

Malagola Michele¹,Polverelli Nicola¹,Martino Massimo²,Patriarca Francesca³,Bruno Benedetto⁴⁵,Giaccone Luisa⁴⁵,Grillo Giovanni⁶,Bramanti Stefania⁷,Bernasconi Paolo⁸,De Gobbi Marco⁹¹⁰,Natale Annalisa¹¹,Terruzzi Elisabetta¹²,Olivieri Attilio¹³,Chiusolo Patrizia¹⁴¹⁵,Carella Angelo Michele¹⁶,Casini Marco¹⁷,Maffini Enrico¹⁸,Nozzoli Chiara¹⁹,Mazza Patrizio²⁰,Bassi Simona²¹,Onida Francesco²²,Vacca Adriana²³,Falcioni Sadia²⁴,Luppi Mario²⁵,Iori Anna Paola²⁶,Pavone Vincenzo²⁷,Skert Cristina²⁸,Carluccio Paola²⁹,Borghero Carlo³⁰,Proia Anna³¹,Selleri Carmine³²,Rubini Vicky³³,Sacchi Nicoletta³⁴,Oldani Elena³⁵,Bonifazi Francesca¹⁸,Ciceri Fabio³⁶,Russo Domenico¹

Affiliation:

1. Department of Clinical and Experimental Sciences, Blood Diseases and Cell Therapies Unit, Bone Marrow Transplant Unit, “Azienda Socio Santiaria Territoriale Spedali Civili” Hospital of Brescia, University of Brescia, Brescia, Italy.

2. Stem Cell Transplant and Cellular Therapies Unit, “Bianco Melacrino Morelli” Hospital, Reggio Calabria, Italy.

3. Haematological Clinic and Transplant Centre, University Hospital of Central Friuli, Dipartimento Area Medica, University of Udine, Udine, Italy.

4. Department of Oncology, Struttura Semplice Dipartimentale Allogeneic Stem Cell Transplantation, “Città della Salute e della Scienza” University Hospital Centre in Turin, Turin, Italy.

5. Division of Haematology, Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy.

6. Division of Haematology and Marrow Transplants, Niguarda Hospital, Milan, Italy.

7. Istituto di Ricerca e Cura a Carattere Scientifico Humanitas Research Hospital, Rozzano, Milan, Italy.

8. Transplant Centre, Unit of Haematology Foundation Istituto di Ricerca e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy.

9. Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.

10. Internal Medicine and Haematology Division, San Luigi University Hospital, Orbassano, Turin, Italy.

11. Haematological Intensive Care, Pescara Hospital, Pescara, Italy.

12. Haematology Unit, San Gerardo Hospital, Monza, Italy.

13. Haematology Clinc, “Ospedali Riuniti” University Hospital of Ancona, Ancona, Italy.

14. Department of Medical Imaging, Radiotherapy, Oncology and Haematology, “A. Gemelli Istituto di Ricerca e Cura a Carattere Scientifico” University Teaching Hospital Foundation, Rome, Italy.

15. Haematology Division, Department of Radiological and Haematological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.

16. Struttura Semplice Dipartimentale Haematological Intensive Care and Cell Therapy Unit, Department of Medical Sciences, “Casa Sollievo della Sofferenza” Foundation, San Giovanni Rotondo, Italy.

17. Haematology and Bone Marrow Transplantation, Bolzano Hospital, Bolzano, Italy.

18. Istituto di Ricerca e Cura a Carattere Scientifico Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

19. Cell Therapy and Transfusion Medicine, “Careggi” University Hospital, Florence, Italy.

20. PO San Giuseppe Moscati, Transplant Division, Department of Haematology, ASL Taranto, Italy.

21. Haematology Unit, “G. da Saliceto” Hospital, Piacenza, Italy.

22. Istituto di Ricerca e Cura a Carattere Scientifico Foundation “Ospedale Maggiore Ca’ Granda Policlinico,” University of Milan, Italy.

23. Hematology Unit, Centro Trapianti di Midollo Osseo P.O. “ A. Businco”, ARNAS Brotzu, Cagliari, Italy.

24. Unit of Haematology and Cell Therapy, “C. e G. Mazzoni” Hospital, Ascoli Piceno, Italy.

25. Division of Hematology Azienda Ospedaliero-Universitaria Modena, Department of Medical and Surgical Sciences, Università degli Studi di Modena e Reggio Emilia, Modena, Italy.

26. Department of Haematology, Oncology and Dermatology, “Umberto I” University Hospital, Roma Sapienza University, Rome, Italy.

27. Department of Haematology and Bone Marrow Transplantation, “Card. G. Panico” Hospital, Tricase, Italy.

28. Unit of Haematology/Bone Marrow Transplantation, Unit “Ospedale dell’Angelo”, Venice, Mestre, Italy.

29. Department of Emergency and Organ Transplantation, Haematology and Stem Cell Transplantation Unit, “Aldo Moro” University of Bari, Bari, Italy.

30. Haematology Department, “San Bortolo” Hospital, Vicenza, Italy.

31. Unit of Haematology and Stem Cell Transplant Centre, “San Camillo” Hospital, Rome, Italy.

32. “San Giovanni di Dio e Ruggi d’Aragona” University Hospital, Salerno, Italy.

33. University of Milan, Italy.

34. Italian Bone Marrow Donor Registry, E.O. Galliera Hospitals, Genoa, Italy.

35. Haematology Unit, “Azienda Socio Santiaria Territoriale Papa Giovanni XXIII”, Bergamo, Italy.

36. Department of Onco-Haematology, Haematology and Bone Marrow Transplantation, Istituto di Ricerca e Cura a Carattere Scientifico San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy.

Abstract

Background. The conditioning regimens with different alkylators at different doses can influence the outcome of allogeneic stem cell transplantation (SCT), but conclusive data are missing. Methods. With the aim to analyze real-life allogeneic SCTs performed in Italy between 2006 and 2017 in elderly patients (aged >60 y) with acute myeloid leukemia or myelodysplastic syndrome, we collected 780 first transplants data. For analysis purposes, patients were grouped according to the type of alkylator included in the conditioning (busulfan [BU]-based; n = 618; 79%; treosulfan [TREO]-based; n=162; 21%). Results. No significant differences were observed in nonrelapse mortality, cumulative incidence of relapse, and overall survival, although in the TREO-based group, we observed a greater proportion of elderly patients (P < 0.001); more active diseases at the time of SCT (P < 0.001); a higher prevalence of patients with either hematopoietic cell transplantation-comorbidity index ≥3 (P < 0.001) or a good Karnofsky performance status (P = 0.025); increased use of peripheral blood stem cells as graft sources (P < 0.001); and greater use of reduced intensity conditioning regimens (P = 0.013) and of haploidentical donors (P < 0.001). Moreover, the 2-y cumulative incidence of relapse with myeloablative doses of BU was significantly lower than that registered with reduced intensity conditioning (21% versus 31%; P = 0.0003). This was not observed in the TREO-based group. Conclusions. Despite a higher number of risk factors in the TREO group, no significant differences were observed in nonrelapse mortality, cumulative incidence of relapse, and overall survival according to the type of alkylator, suggesting that TREO has no advantage over BU in terms of efficacy and toxicity in acute myeloid leukemia and myelodysplastic syndrome.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Transplantation

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