A Two-Step Approach to Myeloablative Haploidentical Transplantation: Low Nonrelapse Mortality and High Survival Confirmed in Patients with Earlier Stage.

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A Two-Step Approach to Myeloablative Haploidentical Transplantation: Low Nonrelapse Mortality and High Survival Confirmed in Patients with Earlier Stage Disease Dolores Grosso, Sameh Gaballa, Onder Alpdogan, Matthew Carabasi, Joanne Filicko-O’Hara, Margaret Kasner, Ubaldo Martinez- Outschoorn, John L. Wagner, William O'Hara, Shannon Rudolph, Inna Chervoneva, Beth Colombe, Patricia Cornett Farley, Phyllis Flomenberg, Barbara Pro, Manish Sharma, Wenyin Shi, Mark Weiss, Neal Flomenberg Biology of Blood and Marrow Transplantation Volume 21, Issue 4, Pages 646-652 (April 2015) DOI: 10.1016/j.bbmt.2014.12.019 Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 The 2-step regimen. Total body irradiation dose is 1.5 Gy per fraction, for a total dose of 12 Gy; CY dose is 60 mg/kg/day. Tacrolimus (Tacro) and mycophenolate mofetil (MMF) are initiated on day −1 for GVHD prophylaxis. Biology of Blood and Marrow Transplantation 2015 21, 646-652DOI: (10.1016/j.bbmt.2014.12.019) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Relapse and nonrelapse mortality. Cumulative incidences of death from relapse and nonrelapse causes. Biology of Blood and Marrow Transplantation 2015 21, 646-652DOI: (10.1016/j.bbmt.2014.12.019) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 CMV reactivation and day +90 immune reconstitution. Patients with CMV reactivation had higher numbers of CD3/4, CD3/8, and NKDim cells at day +90 than patients without CMV reactivation. Differences were the greatest in the CD3/8 populations (P = .000, Mann-Whitney). Biology of Blood and Marrow Transplantation 2015 21, 646-652DOI: (10.1016/j.bbmt.2014.12.019) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Cumulative incidence acute GVHD. Biology of Blood and Marrow Transplantation 2015 21, 646-652DOI: (10.1016/j.bbmt.2014.12.019) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 5 OS of initial versus follow-up 2-step trials. To date, the OS rate in the follow-up 2-step trial recapitulates the findings of the initial 2 step trial in a larger patient population. Biology of Blood and Marrow Transplantation 2015 21, 646-652DOI: (10.1016/j.bbmt.2014.12.019) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions