507 Is There a Stronger Graft-Versus-Leukemia Effect Using HLA-Haplo-Identical Donors Compared to HLA-Identical Sibling Donors?

Track: Poster Abstracts
Saturday, February 14, 2015, 6:45 PM-7:45 PM
Grand Hall CD (Manchester Grand Hyatt)
Olle Ringden, MD, PhD , Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden
Myriam Labopin, MD , EBMT Paris study office / CEREST-TC, Paris, France
Fabio Ciceri, MD , Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan, Italy
Arnon Nagler, MD , The Chaim Sheba Medical Center, Tel-Hashomer, Division of Hematology and Bone Marrow Transplantation, Ramat-Gan, Israel
Mohamad Mohty, MD, PhD , Department of Haematology, Saint Antoine Hospital, Paris, France
Presentation recording not available for download or distribution as requested by the presenting author.
Purpose

Haplo-identical transplants are increasingly used in hematopoietic stem cell transplantation (HSCT) Do haplo-identical transplants have a stronger graft-versus-leukemia (GVL) effect?

Patients and Methods

We analyzed 10,679 patients with acute leukemia undergoing HSCT from an HLA-matched sibling donor (MSD, n=9,815), or a haplo-identical donor (≥ 2 HLA-antigen disparity, n=864) between 2007 – 2012, reported to the European Group for Blood and Marrow Transplantation. In a Cox’ regression model, acute and chronic GVHD were added as time-dependent variables.

Results

In the multivariate analysis, there was no difference in relapse probability between recipients of haplo-identical or MSD grafts. This was seen in T-cell replete and T-cell depleted grafts analyzed separately. Factors of importance for relapse among T-cell replete grafts included remission status at HSCT, Karnofsky score ≤80, acute GVHD ≥grade II, and chronic GVHD (p<10-5). Among patients receiving T-cell depleted grafts, advanced disease (p<10-5) and second remission (p=0.01) compared to first remission were the strongest factors for leukemic relapse. Non-relapse mortality was significantly higher in the haplo group versus MSD transplants among patients receiving T-cell repleted grafts or T-cell depleted grafts (p<10-5). Subsequently, leukemia-free survival was superior in the MSD group of T-cell replete grafts (p<10-5) and T-cell depleted grafts (p=0.0006).

Conclusion

Risk of relapse was the same in patients with acute leukemia in haplo-identical transplant recipients compared with MSD transplants, suggesting a similar GVL effect.

Disclosures:
Nothing To Disclose
See more of: Poster Session 2: GVH/GVL
See more of: Poster Abstracts
<< Previous Presentation | Next Presentation >>