Haploidentical transplantation compared with matched sibling and unrelated donor transplantation for adults with standard‐risk acute lymphoblastic leukaemia in first complete remission

• Published in: British journal of haematology Vol. 179; no. 1; pp. 120 - 130
• Main Authors: Han, Li‐Jie, Wang, Yu, Fan, Zhi‐Ping, Huang, Fen, Zhou, Jian, Fu, Yue‐Wen, Qu, Hong, Xuan, Li, Xu, Na, Ye, Jie‐Yu, Bian, Zhi‐Lei, Song, Yong‐Ping, Huang, Xiao‐Jun, Liu, Qi‐Fa
• Format: Journal Article
• Language: English
• Published: England 01.10.2017
• Subjects: acute lymphoblastic leukaemia; Adolescent; Adult; Combined Modality Therapy; Female; first complete remission; Graft Survival; Graft vs Host Disease - diagnosis; Graft vs Host Disease - etiology; Graft vs Host Disease - prevention & control; haematopoietic stem cell transplantation; haploidentical donor; Haplotypes; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Humans; Incidence; Male; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Recurrence; Remission Induction; Retrospective Studies; Siblings; standard‐risk; Survival Analysis; Transplantation Conditioning; Transplantation, Homologous; Treatment Outcome; Unrelated Donors; Young Adult; first complete remission; haematopoietic stem cell transplantation; haploidentical donor; acute lymphoblastic leukaemia; standard-risk
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1111/bjh.14854

Summary We retrospectively investigated outcomes of haploidentical donor (HID) transplant for adults with standard‐risk acute lymphoblastic leukaemia (ALL) in first complete remission (CR1) compared with human leucocyte antigen (HLA)‐matched sibling donor (MSD) and HLA‐matched unrelated donor (MUD) transplants. A total of 348 adult patients were enrolled, including 127 HID, 144 MSD and 77 MUD recipients. The cumulative incidence of grade II–IV acute graft‐versus‐host disease (aGVHD) was 39·5%, 24·0% and 40·3% for HID, MSD and MUD, respectively (P = 0·020). However, there was no difference in grade III–IV aGVHD (11·4%, 7·7%, 13·5%, respectively, P = 0·468). The 5‐year cumulative transplant‐related mortality was 16·4%, 11·6% and 19·6% (P = 0·162), the 5‐year relapse rate post‐transplantation was 14·8%, 21·1% and 16·7% (P = 0·231), the 5‐year overall survival was 70·1%, 73·7% and 69·8% (P = 0·525), and the 5‐year disease‐free survival was 68·7%, 67·3% and 63·7%, respectively (P = 0·606). Furthermore, the 3‐year GVHD‐free, relapse‐free survival was not different (50·8%, 54·9% and 52·2%, respectively, P = 0·847). Our results indicate that the outcomes of HID transplants are equivalent to those of MSD and MUD, and that HID transplantation is a valid alternative for standard‐risk adults with ALL in CR1 who lack matched donors.