scholarly journals Class I Graft-Versus-Host Mismatch Based on Predicted Indirectly Recognizable HLA Epitopes (PIRCHES) Is Associated with Worse Post-Transplant Outcomes in Patients Receiving Peripheral Blood, T-Cell Replete Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide

2019 ◽  
Vol 25 (3) ◽  
pp. S206
Author(s):  
Joseph Rimando ◽  
Michael Slade ◽  
Feng Gao ◽  
Rizwan Romee ◽  
Chang Liu
Keyword(s):  
T Cell ◽  
Cell Transplantation ◽  
Peripheral Blood ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Class I ◽  
Graft Versus Host ◽  
Post Transplant ◽  
Transplant Outcomes ◽  
Haploidentical Hematopoietic Cell Transplantation

scholarly journals Increased Early Mortality After Fludarabine and Melphalan Conditioning with Peripheral Blood Grafts in Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide

2021 ◽  
Author(s):  
Luke Eastburg ◽  
David Russler-Germain ◽  
John DiPersio ◽  
Thomas Fountaine ◽  
Jeffrey Andolina ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Peripheral Blood ◽  
Hematopoietic Cell Transplantation ◽  
Disease Free Survival ◽  
Hematopoietic Cell ◽  
High Rate ◽  
Cell Transplant ◽  
Post Transplant ◽  
Conditioning Regimens ◽  
Haploidentical Hematopoietic Cell Transplantation

Abstract Due to the evolving use of haploidentical donor grafts in hematopoietic cell transplantation, there is increased need to better understand the risks and benefits of using bone marrow versus peripheral blood grafts, as well as how specific pre-transplantation conditioning regimens impact patient safety and treatment outcomes. We performed a retrospective analysis of 38 patients at two centers who specifically underwent haploidentical hematopoietic cell transplantation using fludarabine plus melphalan-based conditioning regimens with post-transplant cyclophosphamide and peripheral blood donor grafts. We observed an unexpectedly high rate of early non-relapse mortality of 21% at 100 days and 34% at 1-year. In addition, 40% of all patients suffered from severe cytokine release syndrome and 45% of all patients suffered from kidney injury, often necessitating renal replacement therapy. The poor outcomes with 1-year overall survival of 34%, disease-free survival of 29%, and non-relapse mortality of 34% motivate us to reconsider the appropriateness of the combination of fludarabine and melphalan conditioning with T-cell replete peripheral blood grafts in the setting of haploidentical hematopoietic cell transplant with post-transplant cyclophosphamide.

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