Composite GRFS and CRFS Outcomes After Adult Alternative Donor HCT-Reference-Cited by-同舟云学术

Composite GRFS and CRFS Outcomes After Adult Alternative Donor HCT

Published:2020-06-20 Issue:18 Volume:38 Page:2062-2076
ISSN:0732-183X
Container-title:Journal of Clinical Oncology
language:en
Short-container-title:JCO

Author:

Mehta Rohtesh S.¹,Holtan Shernan G.²,Wang Tao³⁴,Hemmer Michael T.³,Spellman Stephen R.⁵,Arora Mukta⁶,Couriel Daniel R.⁷,Alousi Amin M.¹,Pidala Joseph⁸,Abdel-Azim Hisham⁹,Agrawal Vaibhav¹⁰,Ahmed Ibrahim¹¹,Al-Homsi A. Samer¹²,Aljurf Mahmoud¹³,Antin Joseph H.¹⁴,Askar Medhat¹⁵,Auletta Jeffery J.¹⁶,Bhatt Vijaya Raj¹⁷,Chee Lynette¹⁸,Chhabra Saurabh¹⁹,Daly Andrew²⁰,DeFilipp Zachariah²¹,Gajewski James²²,Gale Robert Peter²³,Gergis Usama²⁴,Hematti Peiman²⁵,Hildebrandt Gerhard C.²⁶,Hogan William J.²⁷,Inamoto Yoshihiro²⁸,Martino Rodrigo²⁹,Majhail Navneet S.³⁰,Marks David I.³¹,Nishihori Taiga⁸,Olsson Richard F.³²³³,Pawarode Attaphol³⁴,Diaz Miguel Angel³⁵,Prestidge Tim³⁶,Rangarajan Hemalatha G.¹⁶,Ringden Olle³²,Saad Ayman³⁷,Savani Bipin N.³⁸,Schoemans Hélène³⁹,Seo Sachiko⁴⁰,Schultz Kirk R.⁴¹,Solh Melhem⁴²,Spitzer Thomas²⁰,Storek Jan⁴³,Teshima Takanori⁴⁴,Verdonck Leo F.⁴⁵,Wirk Baldeep⁴⁶,Yared Jean A.⁴⁷,Cahn Jean-Yves⁴⁸,Weisdorf Daniel J.²

Affiliation:

1. Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX

2. University of Minnesota, Minneapolis, MN

3. Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee, WI

4. Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI

5. CIBMTR, National Marrow Donor Program/Be the Match, Minneapolis, MN

6. Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN

7. Utah Blood and Marrow Transplant Program, Salt Lake City, UT

8. Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, FL

9. Division of Hematology, Oncology and Blood & Marrow Transplantation, Children’s Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA

10. Division of Hematology-Oncology, Indiana University School of Medicine, Indianapolis, IN

11. Department of Hematology Oncology and Bone Marrow Transplantation, The Children’s Mercy Hospitals and Clinics, Kansas City, MO

12. New York University Langone Medical Center, New York, NY

13. Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia

14. Division of Hematologic Malignancies, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA

15. Department of Pathology and Laboratory Medicine, Baylor University Medical Center, Dallas, TX

16. Blood and Marrow Transplant Program and Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children’s Hospital, Columbus, OH

17. The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE

18. Royal Melbourne Hospital City Campus, Victoria, Australia

19. Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI

20. Tom Baker Cancer Center, Calgary, Alberta, Canada

21. Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA

22. Oregon Health and Science University, Portland, OR

23. Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom

24. Hematolgic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY

25. Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, WI

26. Markey Cancer Center, University of Kentucky, Lexington, KY

27. Division of Hematology/Bone Marrow Transplantation, Mayo Clinic, Rochester, MN

28. Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

29. Division of Clinical Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain

30. Blood & Marrow Transplant Program, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH

31. Adult Bone Marrow Transplant, University Hospitals Bristol National Health Service Trust, Bristol, United Kingdom

32. Translational Cell Therapy Research, Clintec, Karolinska Institutet, Stockholm, Sweden

33. Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden

34. Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI

35. Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain

36. Blood and Cancer Centre, Starship Children’s Hospital, Auckland, New Zealand

37. Division of Hematology, Ohio State University, Columbus, OH

38. Division of Pediatric Hematology/Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN

39. University Hospital Leuven and Katholieke Universiteit Leuven, Leuven, Belgium

40. Department of Hematology & Oncology, National Cancer Research Center East, Chiba, Japan

41. Department of Pediatric Hematology, Oncology and Bone Marrow Transplant, British Columbia’s Children’s Hospital, The University of British Columbia, Vancouver, BC, Canada

42. The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA

43. Department of Medicine, University of Calgary, Calgary, Alberta, Canada

44. Hokkaido University Hospital, Sapporo, Japan

45. Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands

46. Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA

47. Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD

48. Department of Hematology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France

Abstract

PURPOSE There is no consensus on the best choice of an alternative donor (umbilical cord blood [UCB], haploidentical, one-antigen mismatched [7/8]–bone marrow [BM], or 7/8-peripheral blood [PB]) for hematopoietic cell transplantation (HCT) for patients lacking an HLA-matched related or unrelated donor. METHODS We report composite end points of graft-versus-host disease (GVHD)–free relapse-free survival (GRFS) and chronic GVHD (cGVHD)–free relapse-free survival (CRFS) in 2,198 patients who underwent UCB (n = 838), haploidentical (n = 159), 7/8-BM (n = 241), or 7/8-PB (n = 960) HCT. All groups were divided by myeloablative conditioning (MAC) intensity or reduced intensity conditioning (RIC), except haploidentical group in which most received RIC. To account for multiple testing, P < .0071 in multivariable analysis and P < .00025 in direct pairwise comparisons were considered statistically significant. RESULTS In multivariable analysis, haploidentical group had the best GRFS, CRFS, and overall survival (OS). In the direct pairwise comparison of other groups, among those who received MAC, there was no difference in GRFS or CRFS among UCB, 7/8-BM, and 7/8-PB with serotherapy (alemtuzumab or antithymocyte globulin) groups. In contrast, the 7/8-PB without serotherapy group had significantly inferior GRFS, higher cGVHD, and a trend toward worse CRFS (hazard ratio [HR], 1.38; 95% CI, 1.13 to 1.69; P = .002) than the 7/8-BM group and higher cGVHD and trend toward inferior CRFS (HR, 1.36; 95% CI, 1.14 to 1.63; P = .0006) than the UCB group. Among patients with RIC, all groups had significantly inferior GRFS and CRFS compared with the haploidentical group. CONCLUSION Recognizing the limitations of a registry retrospective analysis and the possibility of center selection bias in choosing donors, our data support the use of UCB, 7/8-BM, or 7/8-PB (with serotherapy) grafts for patients undergoing MAC HCT and haploidentical grafts for patients undergoing RIC HCT. The haploidentical group had the best GRFS, CRFS, and OS of all groups.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

Link

https://ascopubs.org/doi/pdfdirect/10.1200/JCO.19.00396

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