Comparison of myeloablative and reduced intensity conditioning regimens in haploidentical peripheral blood stem cell transplantation.
Dipenkumar ModiSeongho KimAbhinav DeolLois AyashVoravit RatanatharathornJoseph P UbertiPublished in: Bone marrow transplantation (2020)
Limited information is available on the impact of intensity of conditioning regimens in haploidentical peripheral blood stem cell transplant (haploPBSCT) with post-transplant cyclophosphamide (PTcy). We retrospectively compared outcomes of haplo-PBSCT between myeloablative (MAC) (n = 24) and reduced intensity conditioning (RIC) regimens (n = 65). Propensity score-based multivariable analyses were performed to adjust confounding effects of baseline characteristics between both groups. Eighty-nine patients underwent haplo-PBSCT between January 2012 and June 2019. For MAC and RIC, the cumulative incidences of grade III--IV acute GVHD were 4.2% and 3.1%, respectively (p = 0.92), and chronic GVHD were 18.9% and 36.5%, respectively (p = 0.08). Median follow-up for overall survival (OS) after MAC and RIC was 1.86 and 2.2 years, respectively. For MAC and RIC, one-year OS was 68.8% and 67.4%, respectively (p = 0.85); one-year relapse rate was 22.4% and 18.3%, respectively (p = 0.74); one-year relapse-free survival (RFS) was 56% and 59.7%, respectively (p = 0.87); and one-year non-relapse mortality (NRM) was 22% and 21.9%, respectively (p = 0.58). Using propensity score-based multivariable analyses, no difference in OS (HR 0.72, p = 0.51), relapse (SHR 0.63, p = 0.42), RFS (HR 0.74, p = 0.49) and NRM (SHR 1.11, p = 0.87) was noted between RIC and MAC. Our study shows no difference in outcomes between MAC and RIC regimens in haplo-PBSCT.
Keyphrases
- stem cell transplantation
- free survival
- peripheral blood
- high dose
- stem cells
- end stage renal disease
- allogeneic hematopoietic stem cell transplantation
- high intensity
- low dose
- chronic kidney disease
- newly diagnosed
- ejection fraction
- type diabetes
- peritoneal dialysis
- intensive care unit
- acute myeloid leukemia
- acute lymphoblastic leukemia
- risk factors
- adipose tissue
- cardiovascular disease
- patient reported outcomes
- hepatitis b virus
- weight loss
- cardiovascular events
- glycemic control
- health information