期刊
JOURNAL OF CLINICAL ONCOLOGY
卷 34, 期 26, 页码 3141-+出版社
AMER SOC CLINICAL ONCOLOGY
DOI: 10.1200/JCO.2015.66.3476
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资金
- National Cancer Institute [U24-CA076518]
- National Heart, Lung, and Blood Institute
- National Institute of Allergy and Infectious Diseases
- National Heart, Lung, and Blood Institute [5U10HL069294]
- Health Resources and Services Administration [HHSH250201200016C]
- Office of Naval Research [N00014-13-1-0039, N00014-14-1-0028]
- Actinium Pharmaceuticals
- Allos Therapeutics
- Amgen
- National Cancer Institute
- Blue Cross and Blue Shield Association
- Celgene Corporation
- Chimerix, Inc
- Fred Hutchinson Cancer Research Center
- Fresenius-Biotech North America
- Gamida Cell Teva Joint Venture
- Genentech
- Gentium SpA
- Genzyme Corporation
- GlaxoSmithKline
- Health Research, Roswell Park Cancer Institute
- HistoGenetics
- Incyte Corporation
- Jeff Gordon Children's Foundation
- Kiadis Pharma
- Leukemia & Lymphoma Society
- Medac
- Medical College of Wisconsin
- Merck Co
- Millennium: Takeda Oncology
- Milliman USA
- Miltenyi Biotec
- National Marrow Donor Program
- Onyx Pharmaceuticals
- Optum Healthcare Solutions
- Osiris Therapeutics
- Otsuka America Pharmaceutical
- Perkin Elmer
- Remedy Informatics
- Sanofi US
- Seattle Genetics
- Sigma-Tau Pharmaceuticals
- Soligenix
- St. Baldrick's Foundation
- StemCyte
- Global Cord Blood Therapeutics
- Stemsoft Software
- Swedish Orphan Biovitrum
- Tarix Pharmaceuticals
- TerumoBCT
- Teva Neuroscience
- THERAKOS
- University of Minnesota
- University of Utah
- Wellpoint
Purpose Related donor haploidentical hematopoietic cell transplantation (Haplo-HCT) using post-transplantation cyclophosphamide (PT-Cy) is increasingly used in patients lacking HLA-matched sibling donors (MSD). We compared outcomes after Haplo-HCT using PT-Cy with MSD-HCT in patients with lymphoma, using the Center for International Blood and Marrow Transplant Research registry. Materials and Methods We evaluated 987 adult patients undergoing either Haplo-HCT (n = 180) or MSD-HCT (n = 807) following reduced-intensity conditioning regimens. The haploidentical group received graft-versus-host disease (GVHD) prophylaxis with PT-Cy with or without a calcineurin inhibitor and mycophenolate. The MSD group received calcineurin inhibitor-based GVHD prophylaxis. Results Median follow-up of survivors was 3 years. The 28-day neutrophil recovery was similar in the two groups (95% v 97%; P = .31). The 28-day platelet recovery was delayed in the haploidentical group compared with the MSD group (63% v 91%; P = .001). Cumulative incidence of grade II to IV acute GVHD at day 100 was similar between the two groups (27% v 25%; P = .84). Cumulative incidence of chronic GVHD at 1 year was significantly lower after Haplo-HCT (12% v 45%; P < .001), and this benefit was confirmed on multivariate analysis (relative risk, 0.21; 95% CI, 0.14 to 0.31; P < .001). For Haplo-HCT v MSD-HCT, 3-year rates of nonrelapse mortality (15% v 13%; P = .41), relapse/progression (37% v 40%; P = .51), progression-free survival (48% v 48%; P = .96), and overall survival (61% v 62%; P = .82) were similar. Multivariate analysis showed no significant difference between Haplo-HCT and MSD-HCT in terms of nonrelapse mortality (P = .06), progression/relapse (P = .10), progression-free survival (P = .83), and overall survival (P = .34). Conclusion Haplo-HCT with PT-Cy provides survival outcomes comparable to MSD-HCT, with a significantly lower risk of chronic GVHD.
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