First complete remission favours haploidentical haematopoietic stem cell transplantation with post-transplant cyclophosphamide over cord blood transplantation in acute lymphoblastic leukaemia

Tomoyasu Jo; Tomoaki Ueda; Yu Akahoshi; Tadakazu Kondo; Naoyuki Uchida; Masatsugu Tanaka; Hirohisa Nakamae; Noriko Doki; Shuichi Ota; Masashi Sawa; Hiroyuki Ohigashi; Yumiko Maruyama; Nobuyuki Takayama; Tetsuya Nishida; Nobuhiro Hiramoto; Yuta Katayama; Yoshinobu Kanda; Tatsuo Ichinohe; Yoshiko Atsuta; Yasuyuki Arai; Japanese Society for Transplantation and Cellular Therapy (JSTCT)

doi:10.1111/bjh.19372

First complete remission favours haploidentical haematopoietic stem cell transplantation with post-transplant cyclophosphamide over cord blood transplantation in acute lymphoblastic leukaemia

Br J Haematol. 2024 Feb 29. doi: 10.1111/bjh.19372. Online ahead of print.

Authors

Tomoyasu Jo^{1

2}, Tomoaki Ueda³, Yu Akahoshi⁴, Tadakazu Kondo^{1

5}, Naoyuki Uchida⁶, Masatsugu Tanaka⁷, Hirohisa Nakamae⁸, Noriko Doki⁹, Shuichi Ota¹⁰, Masashi Sawa¹¹, Hiroyuki Ohigashi¹², Yumiko Maruyama¹³, Nobuyuki Takayama¹⁴, Tetsuya Nishida¹⁵, Nobuhiro Hiramoto⁵, Yuta Katayama¹⁶, Yoshinobu Kanda¹⁷, Tatsuo Ichinohe¹⁸, Yoshiko Atsuta^{19

20}, Yasuyuki Arai^{1

2}; Japanese Society for Transplantation and Cellular Therapy (JSTCT)

Affiliations

¹ Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
² Center for Research and Application of Cellular Therapy, Kyoto University Hospital, Kyoto, Japan.
³ Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Japan.
⁴ Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
⁵ Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan.
⁶ Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan.
⁷ Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan.
⁸ Department of Hematology, Osaka Metropolitan University Hospital, Osaka, Japan.
⁹ Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
¹⁰ Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan.
¹¹ Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan.
¹² Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
¹³ Department of Hematology, University of Tsukuba Hospital, Tsukuba, Japan.
¹⁴ Department of Hematology, Kyorin University Hospital, Mitaka, Japan.
¹⁵ Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan.
¹⁶ Department of Hematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan.
¹⁷ Division of Hematology, Jichi Medical University, Tochigi, Japan.
¹⁸ Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
¹⁹ Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
²⁰ Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan.

PMID: 38420726
DOI: 10.1111/bjh.19372

Abstract

To assess the benefits of HLA-haploidentical haematopoietic stem cell transplantation using post-transplant cyclophosphamide (PTCy-haplo) relative to those of umbilical cord blood (UCB) transplantation in acute lymphoblastic leukaemia (ALL), we analysed 1999 patients (PTCy-haplo, 330; UCB, 1669), using the nationwide Japanese registry. PTCy-haplo was associated with a significantly higher relapse rate, but lower non-relapse mortality, which results in overall survival and disease-free survival, comparable to those of UCB. Among patients in CR1, PTCy-haplo showed a significantly higher survival than UCB regardless of the CD34⁺ cell dose. Our findings provide valuable insights into the donor selection algorithm in allogeneic HSCT for adult patients with ALL.

Keywords: HLA-haploidentical stem cell transplantation using post-transplant cyclophosphamide; acute lymphoblastic leukaemia; umbilical cord blood.

Grants and funding

Ministry of Education, Culture, Sports, Science and Technology