Oncotarget

Research Papers:

Clofarabine-based reduced intensity conditioning regimen with peripheral blood stem cell graft and post-transplant cyclophosphamide in adults with myeloid malignancies

Patrice Chevallier _, Pierre Peterlin, Alice Garnier, Amandine Le Bourgeois, Beatrice Mahé, Viviane Dubruille, Nicolas Blin, Cyrille Touzeau, Thomas Gastinne, Anne Lok, Yannick Le Bris, Marie C. Béné, Steven Le Gouill, Philippe Moreau and Thierry Guillaume

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Oncotarget. 2018; 9:33528-33535. https://doi.org/10.18632/oncotarget.26083

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Abstract

Patrice Chevallier1, Pierre Peterlin1, Alice Garnier1, Amandine Le Bourgeois1, Beatrice Mahé1, Viviane Dubruille1, Nicolas Blin1, Cyrille Touzeau1, Thomas Gastinne1, Anne Lok1, Yannick Le Bris2, Marie C. Béné2, Steven Le Gouill1, Philippe Moreau1 and Thierry Guillaume1

1Hematology Department, CHU Hotel-Dieu, Nantes, France

2Hematology/Biology Laboratory, CHU Hotel-Dieu, Nantes, France

Correspondence to:

Patrice Chevallier, email: [email protected]

Keywords: allogeneic; clofarabine; post-transplant cyclophosphamide; haplo-identical; PBSC

Received: June 11, 2018     Accepted: August 04, 2018     Published: September 11, 2018

ABSTRACT

Background: The Baltimore reduced-intensity conditioning (RIC) regimen using high-dose post-transplant cyclophosphamide (PTCY) is considered as a standard of care for haploidentical allogeneic stem cell transplantation (allo-SCT). However, it is associated with relatively low survivals and high incidence of relapse, especially when considering myeloid malignancies.

Results: This retrospective study included 36 adults (males n = 18; median age: 60.5 years old; haplodonors n = 27; matched donors n = 8) with myeloid malignancies transplanted between March 2014 and March 2017 at the University Hospital of Nantes. Very encouraging results were observed with a 18-month overall survival (OS), disease-free survival (DFS) and relapse incidence (RI) of 72% ± 7.5%, 63.8 ± 8%, and 25 ± 6% respectively, and a GVHD relapse-free survival (GRFS) of 52.6 ± 8%. In univariate analysis, there were no differences regarding 18-month survivals between patients allografted: i) for acute myeloid leukemia vs myelodysplastic syndrome (OS 70 ± 11% vs 69.2 ± 13%, p = 0.3; DFS 64.7 ± 11% vs 61.5 ± 13%, p = 0.65), or ii) with haplo-identical vs other donors (OS: 66.2 ± 9% vs 88.8 ± 10.4%, p = 0.16; DFS 59 ± 9.5% vs 77.8%, p = 0.6).

Conclusion: The “Clo-Baltimore regimen” is safe and feasible and provides good survivals for patients with myeloid malignancies and haplo-donors.

Methods: Here, we report a variant of the Baltimore regimen, where 1) fludarabine was replaced by clofarabine, 2) bone marrow was replaced by peripheral blood stem cells, and 3) tacrolimus was replaced by cyclosporine, in a “Clo-Baltimore regimen”.


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