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Date publication
septembre 2025
Journal
Bone marrow transplantation
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RUBIO Marie Thérèse
,
Dr DAGUINDAU Etienne
Tous les auteurs :
Jullien M, Brissot E, Daguindau E, Loschi M, Bazarbachi A, Labussiere-Wallet H, Huynh A, Schmidt-Tanguy A, Charbonnier A, Turlure P, Beckerich F, Devillier R, Bay JO, Srour M, Ceballos P, Alani M, Souchet L, Marchand T, Rubio MT, Forcade E, Cornillon J, Chantepie S, Bulabois CE, Villate A, Garnier A, Peterlin P, Le Bourgeois A, Guillaume T, Chevallier P,
Lien Pubmed
Résumé
The optimal reduced-intensity conditioning (RIC) regimen for haploidentical hematopoietic stem cells transplantation (haplo-HSCT) using post-transplant cyclophosphamide as graft-versus-host disease (GVHD) prophylaxis has yet to be determined. Potential RIC regimen for haplo-HSCT in myeloid malignancies include Clofarabine-Baltimore (CloB) and TBF (thiotepa-busulfan-fludarabine). This multicenter retrospective study compared 297 adult patients receiving CloB (n = 59) or TBF (n = 238). The main diagnoses were acute myeloid leukemia (63%), 36% having adverse risk features. Median follow-up was 22.7 months. No significant differences were observed in overall (OS), progression-free (PFS), or GVHD-free relapse-free survival. However, 2-year non-relapse mortality (NRM) was higher after TBF (34% vs 21%, HR: 0.38; 95%CI: 0.20-0.75, p = 0.005), although the relapse incidence was lower (13% vs 23%, HR: 1.94; 95%CI: 0.98-3.87, p = 0.059). A 1:1 propensity score matching allowed the comparison of 53 CloB with 53 TBF. CloB was associated with improved 2-year OS (63% vs 44%, p = 0.02) due to a higher 2-year NRM in the TBF group (48% vs 19%, p = 0.002). By multivariate analysis, CloB remained associated with better OS (HR 0.52, 95% I 0.28-0.99, p = 0.045) and TBF with higher NRM (HR 3.43, 95%CI 1.59-7.41, p = 0.002). These results suggest that CloB is superior to TBF as a RIC regimen prior to haplo-HSCT.
Référence
Bone Marrow Transplant. 2025 09 15;:
