Comparison of hematologic malignancy incidence for patients transplanted using our regimens vs other conditioning regimens
| Conditioning . | NHLBI HLA matched . | NHLBI haploidentical . | Gene therapy . | French group . | CIBMTR . | |||
|---|---|---|---|---|---|---|---|---|
| Alemtuzumab 300 cGy TBI . | Pentostatin/Cy alemtuzumab 300 cGy TBI . | (Chicago, IL, and Riyadh, Saudi Arabia) alemtuzumab 300 cGy TBI . | Alemtuzumab 400 cGy TBI ± PT-Cy . | Pentostatin/Cy alemtuzumab 400 cGy TBI PT-Cy . | Busulfan . | Cy ± ATG busulfan . | Cy ± ATG busulfan (mostly) . | |
| No. enrolled in study | 57 | 24 | 64 | 21∗ | 19∗ | 47 | 234 (79 with mixed chimerism long-term) | 908† |
| TRMN (MDS, AML), No. (%) | 1 (1.8) | 1 (4.2) | 1 (1.6)‡ | 3 (14.3) | 0 | 2 (4.3) | 0 | 2 (0.22)† |
| Hematologic malignancies (including TRMN), No. (%) | 3 (5.3) | 2 (8.3) | 1 (1.6)‡ | 3 (14.3) | 0 | 2 (4.3) | 1 (0.4) | 3 (0.33)† |
| Median time to hematologic malignancy development, y | 3.5 | 1.7 | 3 | 5 | N/A | 4.3 | 6 | 1 |
| No. deceased from hematologic malignancies | 1 | 1 | 0 | 3 | 0 | 2 | ? | ? |
| Graft status | 1 Graft failure, 2 mixed chimerism | 1 Graft failure, 1 mixed chimerism | 1 Graft failure | 3 Graft failure | N/A | Group A | ? | ? |
| Median follow-up, y | 9.1 | 4.0 | 4 | 8.4 | 2.6 | ? | 7.9 | 2.1-3.9 |
| Therapeutic goal | Mixed chimerism | Mixed chimerism | Mixed chimerism | Mixed chimerism | Mixed chimerism | Gene-corrected autologous HSPCs | Full donor chimerism | Full donor chimerism |
| Conditioning . | NHLBI HLA matched . | NHLBI haploidentical . | Gene therapy . | French group . | CIBMTR . | |||
|---|---|---|---|---|---|---|---|---|
| Alemtuzumab 300 cGy TBI . | Pentostatin/Cy alemtuzumab 300 cGy TBI . | (Chicago, IL, and Riyadh, Saudi Arabia) alemtuzumab 300 cGy TBI . | Alemtuzumab 400 cGy TBI ± PT-Cy . | Pentostatin/Cy alemtuzumab 400 cGy TBI PT-Cy . | Busulfan . | Cy ± ATG busulfan . | Cy ± ATG busulfan (mostly) . | |
| No. enrolled in study | 57 | 24 | 64 | 21∗ | 19∗ | 47 | 234 (79 with mixed chimerism long-term) | 908† |
| TRMN (MDS, AML), No. (%) | 1 (1.8) | 1 (4.2) | 1 (1.6)‡ | 3 (14.3) | 0 | 2 (4.3) | 0 | 2 (0.22)† |
| Hematologic malignancies (including TRMN), No. (%) | 3 (5.3) | 2 (8.3) | 1 (1.6)‡ | 3 (14.3) | 0 | 2 (4.3) | 1 (0.4) | 3 (0.33)† |
| Median time to hematologic malignancy development, y | 3.5 | 1.7 | 3 | 5 | N/A | 4.3 | 6 | 1 |
| No. deceased from hematologic malignancies | 1 | 1 | 0 | 3 | 0 | 2 | ? | ? |
| Graft status | 1 Graft failure, 2 mixed chimerism | 1 Graft failure, 1 mixed chimerism | 1 Graft failure | 3 Graft failure | N/A | Group A | ? | ? |
| Median follow-up, y | 9.1 | 4.0 | 4 | 8.4 | 2.6 | ? | 7.9 | 2.1-3.9 |
| Therapeutic goal | Mixed chimerism | Mixed chimerism | Mixed chimerism | Mixed chimerism | Mixed chimerism | Gene-corrected autologous HSPCs | Full donor chimerism | Full donor chimerism |
AML, acute myeloid leukemia; ATG, antithymocyte globulin; CIBMTR, Center for International Blood and Marrow Transplant Research; Cy, cyclophosphamide; HSPC, hematopoietic stem and progenitor cells; MDS, myelodysplastic syndrome; N/A, not applicable; NHLBI, National Heart, Lung, and Blood Institute; PT-Cy, posttransplant cyclophosphamide; TRMN: therapy-related myeloid neoplasm.
One patient was transplanted on study for both protocols.
Two patients transplanted at the NHLBI and who developed therapy-related myeloid neoplasms were included with the NHLBI studies and are not included herein.
Incidence of hematologic malignancies and median duration of follow-up are reported from the time of article publication.