Outcomes of Salvage Haploidentical Transplant with Post-transplant Cyclophosphamide for Rescuing Graft Failure Patients: a Report on behalf of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy.
Fiche publication
Date publication
mai 2019
Journal
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Auteurs
Membres identifiés du Cancéropôle Est :
Dr BERCEANU Ana, Pr RUBIO Marie Thérèse
Tous les auteurs :
Prata PH, Resche-Rigon M, Blaise D, Socié G, Rohrlich PS, Milpied N, Turlure P, Nguyen S, Sirvent A, Bulabois CE, Berceanu A, Charbonnier A, Chevallier P, Bay JO, Neven B, Jubert C, Mohty M, Rubio MT, de Latour RP
Lien Pubmed
Résumé
Prognosis of patients with graft failure is dismal, and re-transplantation is the sole option for long-term survival. To address the interest of haploidentical transplantation as a salvage option in this context, we analyzed data from 24 patients with graft failure or loss re-transplanted with a haploidentical donor who received post-transplant cyclophosphamide (PT-Cy) as graft-versus-host disease prophylaxis (GvHD). Fludarabine-based reduced intensity conditioning was used in 23 patients, and 14 patients received the Baltimore regimen. The median delay between previous and salvage transplantation for graft failure was 63 (39-98) days. Besides PT-Cy, all patients received cyclosporine, and 22 patients also received MMF for GvHD prophylaxis. With a median follow up of 353 (16-2010) days, 1-year OS was 56% (95% CI: 38 - 81). Transplant complications accounted for 80% of deaths. The cumulative incidence of neutrophil engraftment was +30 was 79%. Cumulative incidence of grade II-IV acute GvHD at day-100 was 14%, and 1-year CI of chronic GvHD was 31%. One-year CI of relapse was 13%. Stem cell source did not impact on engraftment, GvHD, relapse nor overall survival. Salvage haploidentical transplant with PT-Cy for rescuing graft failure patients leads to an acceptable 1-year OS and might be a valid option in this poor situation.
Mots clés
Graft failure, Haploidentical transplantation, Post-transplant cyclophosphamide
Référence
Biol. Blood Marrow Transplant.. 2019 May 23;: