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Outcomes of Acute Myelogenous Leukemia Patients Undergoing Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide: Impact of Total Body Irradiation Versus Chemotherapy-Based Myeloablative Conditioning

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Background Optimal myeloablative conditioning (MAC) in the setting of haploidentical hematopoietic cell transplantation (haplo-HCT) with post-transplant cyclophosphamide (PTCy) is unknown. We studied the outcomes of total body irradiation (TBI) vs.… Click to show full abstract

Background Optimal myeloablative conditioning (MAC) in the setting of haploidentical hematopoietic cell transplantation (haplo-HCT) with post-transplant cyclophosphamide (PTCy) is unknown. We studied the outcomes of total body irradiation (TBI) vs. chemotherapy (CT) based MAC regimens in acute myelogenous leukemia (AML) pts undergoing haplo-HCT and reported to EBMT. Methods The study included 1008 AML pts who underwent haplo-HCT during 2010-2018, following TBI (n=89, 9%) or CT (n=919, 91%) based MAC. Regimen intensity was defined by EBMT criteria and the cases with busulfan dose Results In univariate analysis, day 100 incidence of acute GVHD (aGVHD) II-IV and III-VI was 22% vs. 27% (p-0.44) and 12% vs. 12% (p-0.92) in TBI and CT cohorts, respectively. Two-yr total and severe chronic GVHD (cGVHD) incidence were 42% vs. 27% (p In a subgroup analysis of pts Conclusions In this large relatively homogenous cohort of AML patients who received haplo-HCT with PTCy, TBI based MAC was associated with higher incidence of overall cGVHD without impacting other transplant outcomes compared to CT based MAC. A prospective study is needed to validate these findings.

Keywords: haplo hct; haploidentical hematopoietic; cell transplantation; hematopoietic cell; transplantation; myeloablative conditioning

Journal Title: Biology of Blood and Marrow Transplantation
Year Published: 2020

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