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12-01-2018 | Acute leukemia | Article

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

Journal: Bone Marrow Transplantation

Authors: Simone Cesaro, Roberto Crocchiolo, Gloria Tridello, Nina Knelange, Maria Teresa Van Lint, Yener Koc, Fabio Ciceri, Zafer Gülbas, Johanna Tischer, Boris Afanasyev, Benedetto Bruno, Luca Castagna, Didier Blaise, Mohamad Mohty, Giuseppe Irrera, J. L. Diez-Martin, Luca Pierelli, Pietro Pioltelli, Mutlu Arat, Mario Delia, Franca Fagioli, Gerhard Ehninger, Mahmoud Aljurf, Angelo Michele Carella, Hakan Ozdogu, Malgorzata Mikulska, Per Ljungman, Arnon Nagler, Jan Styczynski

Publisher: Nature Publishing Group UK

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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.
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