Bone marrow graft versus peripheral blood graft in haploidentical hematopoietic stem cells transplantation: a retrospective analysis in1344 patients of SFGM-TC registry.
Fiche publication
Date publication
janvier 2024
Journal
Journal of hematology & oncology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RUBIO Marie Thérèse , Dr DAGUINDAU Etienne
Tous les auteurs :
Lacan C, Lambert J, Forcade E, Robin M, Chevallier P, Loron S, Bulabois CÉ, Orvain C, Ceballos P, Daguindau E, Charbonnier A, Chalandon Y, Bernard M, Simand C, Rubio MT, Turlure P, Maertens J, Huynh A, Loschi M, Bay JO, Guillerm G, Alani M, Castilla-Llorente C, Poiré X, Chantepie S, Maillard N, Beguin Y, Marçais A, Cornillon J, Malfuson JV, Maury S, Meuleman N, Villate A, Bekadja MA, Walter-Petrich A, Jacque N, Srour M, Devillier R, Nguyen S
Lien Pubmed
Résumé
The use of peripheral blood (PB) or bone marrow (BM) stem cells graft in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis remains controversial. Moreover, the value of adding anti-thymoglobulin (ATG) to PTCy is unknown. A total of 1344 adult patients received an unmanipulated haploidentical transplant at 37 centers from 2012 to 2019 for hematologic malignancy. We compared the outcomes of patients according to the type of graft, using a propensity score analysis. In total population, grade II-IV and III-IV acute GVHD (aGVHD) were lower with BM than with PB. Grade III-IV aGVHD was lower with BM than with PB + ATG. All outcomes were similar in PB and PB + ATG groups. Then, in total population, adding ATG does not benefit the procedure. In acute leukemia, myelodysplastic syndrome and myeloproliferative syndrome (AL-MDS-MPS) subgroup receiving non-myeloablative conditioning, risk of relapse was twice greater with BM than with PB (51 vs. 22%, respectively). Conversely, risk of aGVHD was greater with PB (38% for aGVHD II-IV; 16% for aGVHD III-IV) than with BM (28% for aGVHD II-IV; 8% for aGVHD III-IV). In this subgroup with intensified conditioning regimen, risk of relapse became similar with PB and BM but risk of aGVHD III-IV remained higher with PB than with BM graft (HR = 2.0; range [1.17-3.43], p = 0.012).
Mots clés
Anti-thymoglobulin, Bone marrow, Graft source, Haploidentical hematopoietic stem cell transplantation, Peripheral stem cell
Référence
J Hematol Oncol. 2024 01 7;17(1):2