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Influence of alternative donor type on early survival after hematopoietic stem cell transplantation for acute myeloid leukemia lacking a sibling donor

Bone Marrow Transplantation volume 55, pages 749–757 (2020)Cite this article

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Abstract

Allogeneic hematopoietic stem cell transplantation is the only potentially curative therapy for acute myeloid leukemia. In the absence of an HLA-matched related or unrelated donor (MRD or MUD), the best alternative donor source remains controversial. Umbilical cord blood and haploidentical donors offer a shorter delay from indication to transplantation. This retrospective multicentre study of a French registry compares overall survival in the 18 months following registration in the absence of a MRD between four types of donors. Between 2012 and 2016, 1302 patients were transplanted using MUD (control, n = 803), mismatched MUD (n = 219), umbilical cord blood (n = 153) and haploidentical (n = 127) donors. Multivariate analyses were conducted for overall survival after registration, after transplant, and transplant-related mortality. After adjustment for variables, the type of donor did not influence any of the three end points. Our results confirmed the significant negative impact of longer time between registration and transplant: HR = 1.04 [1.02–1.06] (p < 0.0001). This indicates a positive correlation between better survival and shorter registration-to-transplantation wait time. In the absence of a sibling donor, the alternative stem cell source does not impact early survival in acute myeloid leukemia patients. The minimization of registration-to-transplantation time should be considered when weighing the alternative donor options.

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Acknowledgements

The authors would like to thank Nicole Raus for data management, Rachel Tipton for critical reading of the manuscript and the French “Agence de Biomedecine” for permission to extract data from their database.

Funding

Clinical research department Grenoble Alpes University Hospital, France

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Authors and Affiliations

  1. CHU (University Hospital) de Grenoble Alpes, Grenoble, France

    Clémence Deteix, Jean-Yves Cahn, Alison Foote & Frédéric Garban

  2. Agence de la Biomédecine, La Plaine Saint Denis, France

    Florence Mesnil, Françoise Audat, Catherine Faucher, Evelyne Marry & Frédéric Garban

  3. Institut Paoli Calmette, Marseille, France

    Sabine Furst

  4. CHU de Bordeaux, Bordeaux, France

    Noel Milpied

  5. CHRU de Lille, LIRIC, INSERM U995, Université de Lille, Lille, France

    Ibrahim Yakoub-Agha

  6. CHU de Montpellier, Montpellier, France

    Nathalie Fegueux

  7. CHU Saint-Louis, Paris, France

    Régis Peffault de Latour

  8. CHU Saint-Antoine, Paris, France

    Mohamad Mohty

  9. CHU de Nantes, Nantes, France

    Patrice Chevallier

  10. Hospices Civils de Lyon, CH Lyon Sud, Lyon, France

    Hélène Labussière Wallet

  11. Oncopole CHU Toulouse, Toulouse, France

    Anne Huynh

  12. CHU de Besançon, Besançon, France

    Fabrice Larosa

  13. Institut Gustave Roussy, Villejuif, France

    Jean-Henri Bourhis

  14. CHU de Caen, Caen, France

    Sylvain Chantepie

  15. CHU de Clermont-Ferrand, Clermont-Ferrand, France

    Jacques-Olivier Bay

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  1. Clémence Deteix
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  17. Françoise Audat
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  18. Alison Foote
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  19. Catherine Faucher
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  20. Evelyne Marry
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  21. Frédéric Garban
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on behalf of the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC)

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Correspondence to Frédéric Garban.

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Deteix, C., Mesnil, F., Furst, S. et al. Influence of alternative donor type on early survival after hematopoietic stem cell transplantation for acute myeloid leukemia lacking a sibling donor. Bone Marrow Transplant 55, 749–757 (2020). https://doi.org/10.1038/s41409-019-0722-y

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