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Harbi S, Brac de la Perriere L, Bouchacourt B, Garciaz S, Pagliardini T, Calmels B, Cecile M, Lefloch AC, Hicheri Y, Hospital MA, Fürst S, Lemarie C, Braticevic C, Legrand F, Bekrieva E, Weiller PJ, Chabannon C, Vey N, Blaise D, Devillier R. Peripheral blood haploidentical hematopoietic cell transplantation for patients aged 70 years and over with acute myeloid leukemia or high-risk myelodysplastic syndrome. Bone Marrow Transplant 2024; 59:101-106. [PMID: 37923831 DOI: 10.1038/s41409-023-02134-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/04/2023] [Accepted: 10/17/2023] [Indexed: 11/06/2023]
Abstract
Haploidentical stem cell transplantation (Haplo-SCT) using non-myeloablative conditioning regimen (NMAC) has extended the feasibility of allogeneic transplantation, notably in older patients. However, there is few data specifically focusing on patients aged 70 years and over with AML and MDS. Thus the benefit of transplantation in this population is still debated. Here we report our single center experience of peripheral blood Haplo-SCT with NMAC and post-transplantation cyclophosphamide in AML and MDS patients aged 70 years and over. We analyzed 50 patients (27 AML, 23 MDS) with a median age of 72 years (70-77), 12/50 (24%) with active disease at Haplo-SCT. Cumulative incidence of grade 3-4 acute and moderate or severe chronic GVHD were 6% and 25%, respectively. Non-relapse mortality (NRM) at day +100 was 0%. NRM, relapse, PFS and OS at 3 years were 16%, 18%, 66%, and 69%, respectively. Among patients who were disease free at 2 years post Haplo-SCT, 88% are living without immunosuppressive treatment. Peripheral blood Haplo-SCT is feasible in selected AML/MDS patients over 70 years, without any early NRM. It produces long-term disease control and survival. Thus, age by itself should not be considered as a formal barrier to Haplo-SCT.
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Affiliation(s)
- Samia Harbi
- Hematology Department, Institut Paoli-Calmettes, Marseille, France
| | | | | | - Sylvain Garciaz
- Hematology Department, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France
| | | | - Boris Calmels
- Cell Therapy Facility, Institut Paoli-Calmettes, CIC-biotherapy, Marseille, France
| | - Maud Cecile
- Hematology Department, Institut Paoli-Calmettes, Marseille, France
| | - Anne-Charlotte Lefloch
- Hematology Department, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France
| | - Yosr Hicheri
- Hematology Department, Institut Paoli-Calmettes, Marseille, France
| | | | - Sabine Fürst
- Hematology Department, Institut Paoli-Calmettes, Marseille, France
| | - Claude Lemarie
- Cell Therapy Facility, Institut Paoli-Calmettes, CIC-biotherapy, Marseille, France
| | | | - Faezeh Legrand
- Hematology Department, Institut Paoli-Calmettes, Marseille, France
| | - Elena Bekrieva
- Hematology Department, Institut Paoli-Calmettes, Marseille, France
| | | | - Christian Chabannon
- Cell Therapy Facility, Institut Paoli-Calmettes, CIC-biotherapy, Marseille, France
| | - Norbert Vey
- Hematology Department, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France
| | - Didier Blaise
- Hematology Department, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France
| | - Raynier Devillier
- Hematology Department, Institut Paoli-Calmettes, Aix Marseille Univ, CNRS, INSERM, CRCM, Marseille, France.
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