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. 2020 Jan;34(1):283-292.
doi: 10.1038/s41375-019-0544-3. Epub 2019 Aug 19.

Haploidentical vs. unrelated allogeneic stem cell transplantation for acute lymphoblastic leukemia in first complete remission: on behalf of the ALWP of the EBMT

Noga Shem-Tov  1 , Christophe Peczynski  2 , Myriam Labopin  2 , Maija Itälä-Remes  3 , Didier Blaise  4 , Hélène Labussière-Wallet  5 , Gerard Socié  6 , Nicolaus Kröger  7 , Stephan Mielke  8 , Boris Afanasyev  9 , Patrice Chevallier  10 , Johanna Tischer  11 , Grzegorz Helbig  12 , Pavel Jindra  13 , Zinaida Peric  14 , Sebastian Giebel  15 , Mohamad Mohty #  16   17 , Arnon Nagler #  18   19
Affiliations

Haploidentical vs. unrelated allogeneic stem cell transplantation for acute lymphoblastic leukemia in first complete remission: on behalf of the ALWP of the EBMT

Noga Shem-Tov et al. Leukemia. 2020 Jan.

Abstract

Unmanipulated haploidentical allogeneic stem cell transplantation (Allo-SCT) has become an attractive alternative for patients lacking HLA-matched sibling or unrelated donors. However, data of outcome in ALL is still scarce. The outcomes of 1234 adult patients with ALL in first complete remission (CR1) who underwent Allo-SCT between 2007 and 2016 were analyzed. Comparison was done between haploidentical donor (Haplo) (136 patients), matched unrelated donor (MUD 10/10) (809 patients), and mismatched unrelated donor (MMUD 9/10) (289 patients). Univariate analysis showed similar outcomes in Haplo, MUD, and MMUD, including OS, LFS, RI, NRM, AGVHD, and CGVHD. In multivariate analysis, Haplo was not associated with worse outcomes compared to MUD 10/10 and MMUD 9/10. Indeed, compared to Haplo, the hazard ratio (HR) for LFS, OS, RI, NRM, AGVHD, and CGVHD were 1.1 (p = 0.7), 0.9 (p = 0.4), 1.35 (p = 0.2), 0.7 (p = 0.2), 1.1 (p = 0.8), and 0.8 (p = 0.2) for MUD, respectively, and 1.1 (p = 0.8), 1.0 (p = 1.0), 1.2 (p = 0.3), 0.8 (p = 0.4), 1.2 (p = 0.3), and 0.9 (p = 0.6) for MMUD, respectively. In conclusion, outcomes of adult patients with ALL in CR1 receiving Haplo Allo-SCT are comparable to MUD or MMUD transplants. Haplo should be considered as a clinically relevant option for patients lacking a matched sibling donor.

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