Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 May 12;4(9):2073-2083.
doi: 10.1182/bloodadvances.2020001499.

Comparing transplant outcomes in ALL patients after haploidentical with PTCy or matched unrelated donor transplantation

Monzr M Al Malki  1 , Dongyun Yang  2 , Myriam Labopin  3 , Boris Afanasyev  4 , Emanuele Angelucci  5 , Asad Bashey  6 , Gérard Socié  7 , Amado Karduss-Urueta  8 , Grzegorz Helbig  9 , Martin Bornhauser  10 , Riitta Niittyvuopio  11 , Arnold Ganser  12 , Fabio Ciceri  13 , Arne Brecht  14 , Yener Koc  15 , Nelli Bejanyan  16 , Francesca Ferraro  17 , Partow Kebriaei  18 , Sally Mokhtari  19 , Armin Ghobadi  17 , Ryotaro Nakamura  1 , Stephen J Forman  1 , Richard Champlin  18 , Mohamad Mohty  3 , Stefan O Ciurea  18 , Arnon Nagler  3   20   21
Affiliations
Multicenter Study

Comparing transplant outcomes in ALL patients after haploidentical with PTCy or matched unrelated donor transplantation

Monzr M Al Malki et al. Blood Adv. .

Abstract

We compared outcomes of 1461 adult patients with acute lymphoblastic leukemia (ALL) receiving hematopoietic cell transplantation (HCT) from a haploidentical (n = 487) or matched unrelated donor (MUD; n = 974) between January 2005 and June 2018. Graft-versus-host disease (GVHD) prophylaxis was posttransplant cyclophosphamide (PTCy), calcineurin inhibitor (CNI), and mycophenolate mofetil (MMF) for haploidentical, and CNI with MMF or methotrexate with/without antithymoglobulin for MUDs. Haploidentical recipients were matched (1:2 ratio) with MUD controls for sex, conditioning intensity, disease stage, Philadelphia-chromosome status, and cytogenetic risk. In the myeloablative setting, day +28 neutrophil recovery was similar between haploidentical (87%) and MUD (88%) (P = .11). Corresponding rates after reduced-intensity conditioning (RIC) were 84% and 88% (P = .47). The 3-month incidence of grade II-IV acute GVHD (aGVHD) and 3-year chronic GVHD (cGVHD) was similar after haploidentical compared with MUD: myeloablative conditioning, 33% vs 34% (P = .46) for aGVHD and 29% vs 31% for cGVHD (P = .58); RIC, 31% vs 30% (P = .06) for aGVHD and 24% vs 29% for cGVHD (P = .86). Among patients receiving myeloablative regimens, 3-year probabilities of overall survival were 44% and 51% with haploidentical and MUD (P = .56). Corresponding rates after RIC were 43% and 42% (P = .6). In this large multicenter case-matched retrospective analysis, despite the limitations of a registry-based study (ie, unavailability of key elements such as minimal residual disease testing), our analysis indicated that outcomes of patients with ALL undergoing HCT from a haploidentical donor were comparable with 8 of 8 MUD transplantations.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Comparison of survival outcomes between patients undergoing Haplo and MUD HCT. (A) OS post-MAC. (B) OS post-RIC.
See this image and copyright information in PMC

References

    1. Cornelissen JJ, van der Holt B, Verhoef GE, et al. ; Dutch-Belgian HOVON Cooperative Group . Myeloablative allogeneic versus autologous stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission: a prospective sibling donor versus no-donor comparison. Blood. 2009;113(6):1375-1382. - PubMed
    1. Fielding AK, Richards SM, Chopra R, et al. ; Eastern Cooperative Oncology Group . Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL); an MRC UKALL12/ECOG 2993 study. Blood. 2007;109(3):944-950. - PubMed
    1. Goldstone AH, Richards SM, Lazarus HM, et al. . In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993). Blood. 2008;111(4):1827-1833. - PubMed
    1. Thomas X, Boiron JM, Huguet F, et al. . Outcome of treatment in adults with acute lymphoblastic leukemia: analysis of the LALA-94 trial. J Clin Oncol. 2004;22(20):4075-4086. - PubMed
    1. Lee S, Cho B-S, Kim S-Y, et al. . Allogeneic stem cell transplantation in first complete remission enhances graft-versus-leukemia effect in adults with acute lymphoblastic leukemia: antileukemic activity of chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2007;13(9):1083-1094. - PubMed

Publication types

Substances