Comparison of HLA-mismatched unrelated donor transplantation with post-transplant cyclophosphamide versus HLA-haploidentical transplantation in patients with active acute myeloid leukemia

Baron, Frederic; Labopin, Myriam; Tischer, Johanna; Ciceri, Fabio; Raiola, Anna Maria; Blaise, Didier; Sica, Simona; Vydra, Jan; Fanin, Renato; Diez-Martin, Jose Luis; Bulabois, Claude Eric; Stolzel, Friedrich; Busca, Alessandro; Jindra, Pavel; Koc, Yener; Chevallier, Patrice; Forcade, Edouard; Roesler, Wolf; Passweg, Jakob; Kulagin, Alexander; Carella, Angelo Michele; Simand, Celestine; Bazarbachi, Ali; Pioltelli, Pietro; Nagler, Arnon und Mohty, Mohamad (2022): Comparison of HLA-mismatched unrelated donor transplantation with post-transplant cyclophosphamide versus HLA-haploidentical transplantation in patients with active acute myeloid leukemia. In: Bone Marrow Transplantation, Bd. 57, Nr. 11: S. 1657-1663

Abstract

HLA-haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HCT) is frequently used as treatment for patients with active acute myeloid leukemia (AML). Here, we investigated whether 9/10 HLA-mismatched unrelated donor transplantation (MMUD-HCT) with post-transplant cyclophosphamide (PTCy) is an adequate alternative. Inclusion criteria in this retrospective registry study consisted of adult patients, first HCT with a Haplo donor or MMUD between 2010 and 2020 using PTCy as graft-versus-host disease (GVHD) prophylaxis, and primary refractory or relapsed disease. MMUD patients were pair-matched 1 to 2 with Haplo-recipients. A total of 73 MMUD patients met the inclusion criteria. Their data were compared to those of 146 Haplo patients in a matched-pair analysis. Median follow-up was 27 months in MMUD patients and 36 months in Haplo recipients. Two-year incidences of relapse and non-relapse mortality (NRM) were 40% and 18% in MMUD patients, respectively, versus 50% (P = 0.23) and 24% (P = 0.18) in Haplo recipients. Two-year leukemia-free survival (LFS) and overall survival (OS) was 42% and 46% in MMUD recipients, respectively, versus 26% (P = 0.1) and 28% (P = 0.061) in Haplo-patients. In conclusions, in AML patients with active disease at transplantation, MMUD-HCT results in at least comparable outcomes to Haplo-HCT when PTCy is applied. We report a paired-matched analysis of HLA-mismatched unrelated donor transplantation (MMUD, n = 73) versus HLA-haploidentical transplantation (n = 146) in AML patients with active disease at transplantation. Two-year leukemia-free survival and overall survival was 42% and 46% in MMUD recipients, respectively, versus 26% (P = 0.1) and 28% (P = 0.061) in Haplo-patients.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0268-3369
• Sprache: Englisch