Unmanipulated haploidentical versus HLA-matched sibling allogeneic hematopoietic stem cell transplantation in relapsed/refractory acute myeloid leukemia: a retrospective study on behalf of the ALWP of the EBMT: Bone Marrow Transplantation

G Battipaglia, A Boumendil, M Labopin, F Ciceri, J Tischer, M Stelljes, G Ehninger, D Beelen, J Finke, MT Van Lint, M Eder, B Afanasyev, R Fanin, M Mohty, A Ruggeri, A Nagler

Research output: Contribution to journalArticlepeer-review

Abstract

Refractory or relapsed acute myeloid leukemia (R/R-AML) has poor prognosis. Allogeneic hematopoietic stem-cell transplantation (HSCT) may provide cure in this scenario. We compared outcomes of HSCT from HLA-identical (HLA-id, n = 1654) sibling or haploidentical (Haplo, n = 389) donors in patients with R/R-AML, performed during the period 2007–2015. The Haplo group included patients receiving an unmanipulated graft (post-transplant cyclophosphamide, n = 278; in vivo T-cell depletion, n = 95; or both, n = 16). Median age at HSCT was 52 (range 18–74) years. Median follow-up was 16 and 22 months for HLA-id sibling and Haplo recipients, respectively (p = 0.11). Compared to MSD, Haplo HSCT were performed more recently (2013 vs 2011, p <0.01), at longer interval from diagnosis (7 vs 5 months, p <0.01), more frequently using bone marrow as stem cell source (47% vs 8%, p <0.01) and with a reduced intensity conditioning regimen (50% vs 43%, p = 0.03). Engraftment was higher (93% vs 83%, p <0.01) in HLA-id sibling. In multivariate analysis, Haplo HSCT was associated with lower GVHD/relapse-free survival, inferior LFS and OS and higher NRM, mainly due to a higher rate of infections (41% vs 25%, p <0.01). For R/R-AML, HLA-id sibling donors remain the gold standard, when available, due to higher mortality in Haplo without significant gain in disease control. © 2019, Springer Nature Limited.
Original languageEnglish
Pages (from-to)1499-1510
Number of pages12
JournalBone Marrow Transplantation
Volume54
Issue number9
DOIs
Publication statusPublished - 2019

Fingerprint Dive into the research topics of 'Unmanipulated haploidentical versus HLA-matched sibling allogeneic hematopoietic stem cell transplantation in relapsed/refractory acute myeloid leukemia: a retrospective study on behalf of the ALWP of the EBMT: Bone Marrow Transplantation'. Together they form a unique fingerprint.

Cite this