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Bone Marrow Transplant. 2018 Apr;53(4):422-430. doi: 10.1038/s41409-017-0016-1. Epub 2018 Jan 12.

Comparable survival using a CMV-matched or a mismatched donor for CMV+ patients undergoing T-replete haplo-HSCT with PT-Cy for acute leukemia: a study of behalf of the infectious diseases and acute leukemia working parties of the EBMT.

Author information

1
Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
2
ASST Bergamo Ovest, Treviglio, Italy. roberto.crocchiolo@gmail.com.
3
BMT Data Office, Leiden, The Netherlands.
4
Ospedale San Martino, Genova, Italy.
5
Medical Park Hospitals, Antalya, Turkey.
6
Ospedale S.Raffaele s.r.l., Milano, Italy.
7
Anadolu Medical Center Hospital, Kocaeli, Turkey.
8
Klinikum Grosshadern, Munich, Germany.
9
First State Pavlov Medical University of St., Petersburg, Russia.
10
A.O.U Citta della Salute e della Scienza, Turin, Italy.
11
Istituto Clinico Humanitas, Milano, Italy.
12
Institut Paoli Calmettes, Marseille, France.
13
Hospital Saint Antoine, Paris, France.
14
Azienda Ospedaliera Bianchi-Melacrino-Morelli di Reggio Calabria, Reggio Calabria, Italy.
15
Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain.
16
Ospedale S. Camillo, Rome, Italy.
17
Ospedale San Gerardo, Monza, Italy.
18
Florence Nightingale Sisli Hospital, Istanbul, Turkey.
19
U.O. Ematologia con Trapianto, Bari, Italy.
20
Ospedale Infantile Regina Margherita, Torino, Italy.
21
Universitaetsklinikum Dresden, Dresden, Germany.
22
King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
23
IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
24
Baskent University Hospital, Yuregir Adana, Turkey.
25
University of Genoa, Genoa, Italy.
26
Karolinska University Hospital, Stockholm, Sweden.
27
Chaim Sheba Medical Center, Tel-Hashomer, Israel and Acute Leukemia Working Party Paris Office, Hopital Saint-Antoine, Université Pierre & Marie Curie, Paris, France.
28
University Hospital Collegium Medicum UMK, Bydgoszcz, Poland.

Abstract

The role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4-24.8) and 18.8% (95% CI: 13.8-25.5) in the CMV D+/R+ and D-/R+ pairs, respectively (p = 0.40). Similarly, 1-year OS was 55.1% (95% CI: 50.1-58.0) and 55.7% (95% CI: 48.0-62.8) in the same groups (p = 0.50). The other main outcomes were comparable. No difference in NRM nor OS was observed after stratification for the intensity of conditioning and multivariate anaysis confirmed the lack of significant association with NRM or OS. In conclusion, the choice of a CMV-seronegative donor did not impair early survival of CMV-seropositive patients with acute leukemia after a first, non T-cell depleted haploidentical HSCT and PT-Cy among this series of 983 consecutive patients. Future research may focus on the assessment of the hierarchy of all the donor variables.

PMID:
29330396
DOI:
10.1038/s41409-017-0016-1
[Indexed for MEDLINE]

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