Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Mohty, Mohamadsearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccess

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    Total Body Irradiation Plus Fludarabine Versus Busulfan Plus Fludarabine As A Myeloablative Conditioning for Adults with Acute Myeloid Leukemia Treated with Allogeneic Hematopoietic Cell Transplantation. A Study on Behalf of The Acute Leukemia Working Party of The EBMT
    (2022) Swoboda, Ryszard; Labopin, Myriam; Giebel, Sebastian; Schroeder, Thomas; Kroeger, Nicolaus; Arat, Mutlu; Savani, Bipin; Spyridonidis, Alexandros; Hamladji, Rose-Marie; Potter, Victoria; Berceanu, Ana; Yakoub-Agha, Ibrahim; Rambaldi, Alessandro; Ozdogu, Hakan; Sanz, Jaime; Nagler, Arnon; Mohty, Mohamad; 36460819
    Cyclophosphamide is frequently substituted with fludarabine (Flu) in conditioning regimens before allogeneic hematopoietic cell transplantation (allo-HCT). We aimed to compare retrospectively, total body irradiation (12 Gy) plus Flu (FluTBI12) versus busulfan (Bu) plus Flu (FB4) as a myeloablative conditioning before allo-HCT in patients with acute myeloid leukemia (AML). Out of 3203 patients who met the inclusion criteria, 109 patients treated with FluTBI12 and 213 treated with FB4 were included in a final matched-pair analysis. In both groups, median patient age was 41 years, first or second complete remission (CR1/CR2) proportion was 78%/22%, allo-HCT from an unrelated donor was performed in 78% of patients. The probabilities of leukemia-free survival and overall survival at 2 years in FluTBI12 and FB4 groups were 65% vs. 60% (p = 0.64) and 70% vs. 72% (p = 0.87), respectively. The cumulative incidence of relapse was 19% vs. 29% (p = 0.11), while non-relapse mortality was 16% vs. 11%, respectively (p = 0.13). There were no statistical differences in both acute and chronic graft-versus-host disease (GVHD) incidence. The probability of GVHD-free, relapse-free survival (GRFS) was 49% for both groups. FluTBI12 and FB4 are comparable myeloablative regimens before allo-HCT in AML patients transplanted in CR1 and CR2.
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    Outcomes of Total Body Irradiation-Versus Chemotherapy-Based Myeloablative Conditioning Regimen in Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide for Acute Lymphoblastic Leukemia: ALWP of the EBMT Study
    (2019) Dholaria, Bhagirathbhai; Labopin, Myriam; Angelucci, Emanuele; Tischer, Johanna; Arat, Mutlu; Ciceri, Fabio; Gulbas, Zafer; Ozdogu, Hakan; Sica, Simona; Diez-Martin, Jose L; Koc, Yener; Apperley, Jane; Socie, Gerard; Giebel, Sebastian; Savani, Bipin N.; Nagler, Arnon; Mohty, Mohamad; https://orcid.org/0000-0002-8902-1283; AAD-5542-2021
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    Comparable Survival Using A CMV-Matched Or A Mismatched Donor For CMV Plus 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
    (2018) Cesaro, Simone; Crocchiolo, Roberto; Tridello, Gloria; Knelange, Nina; Van Lint, Maria Teresa; Koc, Yener; Ciceri, Fabio; Gulbas, Zafer; Tischer, Johanna; Afanasyev, Boris; Bruno, Benedetto; Castagna, Luca; Blaise, Didier; Mohty, Mohamad; Irrera, Giuseppe; Diez-Martin, J. L.; Pierelli, Luca; Pioltelli, Pietro; Arat, Mutlu; Delia, Mario; Fagioli, Franca; Ehninger, Gerhard; Aljurf, Mahmoud; Carella, Angelo Michele; Ozdogu, Hakan; Mikulska, Malgorzata; Ljungman, Per; Nagler, Arnon; Styczynski, Jan; https://orcid.org/0000-0002-8902-1283; 29330396; AAD-5542-2021
    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+P/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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    Comparative study of treosulfan plus Fludarabine (FT14) with busulfan plus Fludarabine (FB4) for acute myeloid leukemia in first or second complete remission: An analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP)
    (2022) Gavriilaki, Eleni; Labopin, Myriam; Sakellari, Ioanna; Salmenniemi, Urpu; Yakoub-Agha, Ibrahim; Potter, Victoria; Berceanu, Ana; Rambaldi, Alessandro; Hilgendorf, Inken; Kroeger, Nicolaus; Mielke, Stephan; Zuckerman, Tsila; Sanz, Jaime; Busca, Alessandro; Ozdogu, Hakan; Anagnostopoulos, Achilles; Savani, Bipin; Giebel, Sebastian; Bazarbachi, Ali; Spyridonidis, Alexandros; Nagler, Arnon; Mohty, Mohamad; 36138068
    Different doses of treosulfan plus fludarabine have shown advantage over reduced intensity regimens. However, data comparing higher doses of treosulfan to myeloablative busulfan are limited. Thus, we compared outcomes between FT14 (fludarabine 150/160 mg/m(2) and treosulfan 42 g/m(2), or FT14) over FB4 (fludarabine 150/160 mg/m(2) and busulfan 12.8 mg/kg). We retrospectively studied patients from European Society for Blood and Marrow Transplantation registry: a) adults diagnosed with acute myeloid leukemia (AML), b) recipients of first allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated or sibling donor (2010-2020), c) HSCT at first or second complete remission, d) conditioning with FT14 or FB4. FT14 recipients (n = 678) were older, with higher rates of secondary AML, unrelated donors, peripheral blood grafts, and adverse cytogenetics, but lower percentage of female donor to male recipient compared to FB4 (n = 2025). Analysis was stratified on age. In patients aged < 55 years, FT14 was associated with higher relapse incidence (RI) and lower Leukemia-Free Survival (LFS). In patients aged >= 55 years, acute GVHD CI was higher in FB4, without significant differences in other outcomes. Although FT14 has been used for higher-risk HSCT patients, our large real-world multicenter study suggests that FB4 is associated with better outcomes compared to FT14 in younger patients.