Eighty patients with high-risk hematologic malignancies underwent unmanipulated, G-CSF–primed BM transplantation from an haploidentical family donor. Patients were transplanted in first or second complete remission (CR, standard-risk: n =45) or in > second CR or active disease (high-risk: n =35). The same regimen for GVHD prophylaxis was used in all cases. The cumulative incidence (CI) of neutrophil engraftment was 93% 0.1%. The 100-day CIs for II-IV and III-IV grade of acute GVHD were 24% 0.2% and 5% 0.6%, respectively. The 2-year CI of extensive chronic GVHD was 6% 0.1%. The 1-year CI of treatment-related mortality was 36% 0.3%. After a median follow-up of 18 months, 36 of 80 (45%) patients are alive in CR. The 3-year probability of overall and disease-free survival for standard-risk and high-risk patients was 54% 8% and 33% 9% and 44% 8% and 30% 9%, respectively. In multivariate analysis, disease-free survival was significantly better for patients who had standard-risk disease and received transplantations after 2007. We conclude that unmanipulated, G-CSF–primed BM transplantation from haploidentical family donor provides very encouraging results in terms of engraftment rate, incidence of GVHD and survival and represents a feasible, valid alternative for patients with high-risk malignant hematologic diseases, lacking an HLA identical sibling and in need to be urgently transplanted.

Di Bartolomeo, P., Santarone, S., De Angelis, G., Picardi, A., Cudillo, L., Cerretti, R., et al. (2013). Haploidentical, unmanipulated, G-CSF-primed bone marrow transplantation for patients with high-risk hematologic malignancies. BLOOD, 121(5), 849-857 [10.1182/blood-2012-08-453399].

Haploidentical, unmanipulated, G-CSF-primed bone marrow transplantation for patients with high-risk hematologic malignancies

Picardi, Alessandra;Cudillo, Laura;Cerretti, Raffaella;Adorno, Gaspare;Sarmati, Loredana;Arcese, William
2013-01-31

Abstract

Eighty patients with high-risk hematologic malignancies underwent unmanipulated, G-CSF–primed BM transplantation from an haploidentical family donor. Patients were transplanted in first or second complete remission (CR, standard-risk: n =45) or in > second CR or active disease (high-risk: n =35). The same regimen for GVHD prophylaxis was used in all cases. The cumulative incidence (CI) of neutrophil engraftment was 93% 0.1%. The 100-day CIs for II-IV and III-IV grade of acute GVHD were 24% 0.2% and 5% 0.6%, respectively. The 2-year CI of extensive chronic GVHD was 6% 0.1%. The 1-year CI of treatment-related mortality was 36% 0.3%. After a median follow-up of 18 months, 36 of 80 (45%) patients are alive in CR. The 3-year probability of overall and disease-free survival for standard-risk and high-risk patients was 54% 8% and 33% 9% and 44% 8% and 30% 9%, respectively. In multivariate analysis, disease-free survival was significantly better for patients who had standard-risk disease and received transplantations after 2007. We conclude that unmanipulated, G-CSF–primed BM transplantation from haploidentical family donor provides very encouraging results in terms of engraftment rate, incidence of GVHD and survival and represents a feasible, valid alternative for patients with high-risk malignant hematologic diseases, lacking an HLA identical sibling and in need to be urgently transplanted.
31-gen-2013
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/15 - MALATTIE DEL SANGUE
English
Adolescent; Adult; Aged; Child; Child, Preschool; Disease-Free Survival; Female; Follow-Up Studies; Graft Survival; Graft vs Host Disease; Granulocyte Colony-Stimulating Factor; Hematologic Neoplasms; Humans; Male; Middle Aged; Neutrophils; Risk Factors; Survival Rate; Time Factors; Transplantation, Homologous; Bone Marrow Transplantation; Living Donors
Di Bartolomeo, P., Santarone, S., De Angelis, G., Picardi, A., Cudillo, L., Cerretti, R., et al. (2013). Haploidentical, unmanipulated, G-CSF-primed bone marrow transplantation for patients with high-risk hematologic malignancies. BLOOD, 121(5), 849-857 [10.1182/blood-2012-08-453399].
Di Bartolomeo, P; Santarone, S; De Angelis, G; Picardi, A; Cudillo, L; Cerretti, R; Adorno, G; Angelini, S; Andreani, M; De Felice, L; Rapanotti, Mc; Sarmati, L; Bavaro, P; Papalinetti, G; Di Nicola, M; Papola, F; Montanari, M; Nagler, A; Arcese, W
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/248354
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