Transplantation with post Transplant Cyclophosphamide for Patients - PowerPoint PPT Presentation

Haploidentical Hematopoietic Stem Cell Transplantation with post Transplant Cyclophosphamide for Patients Over 70 Years Samia Harbi, MD 23/11/2018 - 18 e Congrès SFGM-TC-Nice

Introduction : Haplo-SCT ✓ Low incidence of GVHD using PT-Cy ✓ Similar Outcome compared to MRD and UD Atlanta PFS Bashey et al. JCO 2013 Raiola et al. BBMT 2014

Introduction : Haplo-SCT ✓ Low incidence of GVHD using PT-Cy ✓ Similar Outcome compared to MRD and UD Genova Atlanta PFS OS SIB: 176 MUD: 43 MMD: 43 UCB: 105 HRD: 92 Bashey et al. JCO 2013 Raiola et al. BBMT 2014

Introduction : Haplo-SCT ✓ Low incidence of GVHD using PT-Cy ✓ A preferred strategy for older patients? ✓ Similar Outcome compared to MRD and UD Genova > 55 ans Atlanta IPC PFS PFS OS P = .02: HRD/UD SIB: 176 MUD: 43 MRD:47 MMD: 43 UD:63 UCB: 105 HRD: 92 Haplo:31 Bashey et al. JCO 2013 Raiola et al. BBMT 2014 Blaise et al. BBMT 2016

Introduction : Haplo-SCT for Older Patients Johns Hopkins (N = 271) Age (50-75) • Bone marrow • Cy-Flu-TBI2 • PT-Cy •

Introduction : Haplo-SCT for Older Patients Johns Hopkins (N = 271) Age (50-75) • Bone marrow • Cy-Flu-TBI2 • PT-Cy • OS Kasamon et al. JCO 2015

Introduction : Haplo-SCT for Older Patients Johns Hopkins (N = 271) IPC (N = 46) Age (50-75) Age (50-73) • • Bone marrow PBSC • • Cy-Flu-TBI2 Cy-Flu-TBI2 • • PT-Cy PT-Cy • • OS Devillier et al. BJH 2017 Kasamon et al. JCO 2015

Introduction : Haplo-SCT for Older Patients Johns Hopkins (N = 271) IPC (N = 46) Age (50-75) Age (50-73) • • Bone marrow PBSC • • Cy-Flu-TBI2 Cy-Flu-TBI2 • • PT-Cy PT-Cy • • Aim : To Evaluate the Feasibility of Haplo-SCT in OS Patients Over 70 years of Age Devillier et al. BJH 2017 Kasamon et al. JCO 2015

Patient and Transplant Characteristics Selection Criteria • Age ≥ 70y • Haplo-SCT for malignancies • PT-CY as GVHD prophylaxis • IPC + ICH • 2012-2018

Patient and Transplant Characteristics All Patients (N = 33) Age 71 (70 - 77) Disease Selection Criteria AML 13 39% MDS 13 39% • Age ≥ 70y MPN 2 6% ALL 2 6% • Haplo-SCT for malignancies NHL 3 9% • PT-CY as GVHD prophylaxis High DRI 10 30% HCT-CI ≥ 3 21 64% • IPC + ICH NMAC FluCyTBI 27 82% • 2012-2018 PBSC 30 91% Child 31 94% 2nd Allo 2 6%

Results : acute GVHD

Results : chronic GVHD Severe = 3% (n=1)

Results : NRM and Relapse

Results : PFS and OS

Results : GRFS

Results : Impact of HCT-CI

Results : Impact of conditioning regimen

Conclusions • Haplo-SCT is feasible for patients over 70 years ✓ Low GVHD rate using PT-Cy ✓ No impact of HCT-CI • Perspectives ✓ Comprehensive geriatric assessment-based strategy ✓ QOL assessment ✓ Prospective evaluation in homogeneous disease group

Acknowledgments Transplant Program Leukemia Team Lymphoma Team D Blaise N Vey R Bouabdallah S Fürst A Charbonnier JM Schiano L Castagna J Rey AM Stoppa A Granata E D’Incan D Coso F Legrand C Saillard T Aurran R Devillier MA Hospital R Noël C Montes de oca S Bonnet V Maisano T Pagliardini B Mohty PJ Weiller Oncogeriatric team Biopathology F Rousseau Nursing Staff A Murati M Cecile L Caymaris V Gelsi-Boyer C Braticevic AC Lhoumeau Cellular Therapy Unit MJ Mozziconacci C Chabannon C Lemarie Scientific Advisor B Calmels B Andersson