Comparable Outcomes for Hematologic Malignancies after HLA-Haploidentical Transplantation with Posttransplantation Cyclophosphamide and HLA-Matched TransplantationReport as inadecuate




Comparable Outcomes for Hematologic Malignancies after HLA-Haploidentical Transplantation with Posttransplantation Cyclophosphamide and HLA-Matched Transplantation - Download this document for free, or read online. Document in PDF available to download.

Advances in HematologyVolume 2015 2015, Article ID 431923, 9 pages

Review ArticleSidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21287, USA

Received 28 September 2015; Accepted 27 October 2015

Academic Editor: Suparno Chakrabarti

Copyright © 2015 Shannon R. McCurdy and Ephraim J. Fuchs. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The implementation of high-dose posttransplantation cyclophosphamide PTCy has made HLA-haploidentical haplo blood or marrow transplantation BMT a cost effective and safe alternative donor transplantation technique, resulting in its increasing utilization over the last decade. We review the available retrospective comparisons of haplo BMT with PTCy and HLA-matched BMT in adults with hematologic malignancies. The examined studies demonstrate no difference between haplo BMT with PTCy and HLA-matched BMT with regard to acute graft-versus-host disease aGVHD, nonrelapse mortality, and overall survival. Chronic GVHD occurred less frequently after haplo BMT with PTCy compared with HLA-matched BMT utilizing standard GVHD prophylaxis. In addition, patients with a high risk of relapse by the disease risk index had a suggestion of improved progression-free and overall survival after haplo BMT with PTCy when compared with a historical cohort of HLA-matched BMT in one analysis. Furthermore, in Hodgkin lymphoma relapse and progression-free survival were improved in the haplo BMT with PTCy compared with the HLA-matched BMT cohort. These findings support the use of this transplantation platform when HLA-matched related donors MRDs are unavailable and suggest that clinical scenarios exist in which haplo BMT may be preferred to HLA-matched BMT, which warrant further investigation.





Author: Shannon R. McCurdy and Ephraim J. Fuchs

Source: https://www.hindawi.com/



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