Haploidentical transplant for myelodysplastic syndrome: registry-based comparison with identical sibling transplant

• Published in: Leukemia Vol. 30; no. 10; pp. 2055 - 2063
• Main Authors: Wang, Y, Wang, H-X, Lai, Y-R, Sun, Z-M, Wu, D-P, Jiang, M, Liu, D-H, Xu, K-L, Liu, Q-F, Liu, L, Wang, J-B, Gao, F, Ou-Yang, J, Gao, S-J, Xu, L-P, Huang, X-J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.10.2016; Nature Publishing Group
• Subjects: 631/67/1990/1673; 692/67; Adolescent; Adult; Algorithms; Anemia; Antigens; Bone marrow; Bone marrow transplantation; Cancer; Cancer Research; Care and treatment; Child; Child, Preschool; Critical Care Medicine; Development and progression; Diagnosis; Disease-Free Survival; Female; Haplotypes; Hematology; Hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic stem cells; Histocompatibility - immunology; Histocompatibility antigen HLA; HLA Antigens - pharmacology; Humans; Intensive; Internal Medicine; Leukemia; Leukocytes; Male; Medicine; Medicine & Public Health; Middle Aged; Myelodysplastic syndrome; Myelodysplastic syndromes; Myelodysplastic Syndromes - mortality; Myelodysplastic Syndromes - therapy; Oncology; Oncology, Experimental; original-article; Patients; Recurrence; Registries; Siblings; Statistical analysis; Stem cell transplantation; Stem cells; Survival; Survival Rate; Tissue Donors; Transplantation; Transplants & implants; White blood cell count; Young Adult; China; Beijing China
• ISSN: 0887-6924; 1476-5551
• DOI: 10.1038/leu.2016.110

Encouraging results from a small sample of patients with myelodysplastic syndrome (MDS) undergoing haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT) must be extended. Furthermore, an algorithm derived from a comparison of the outcomes of HID and identical-sibling donor (ISD) HSCT must be established. Therefore, the outcomes of 454 MDS patients who underwent HSCT from HIDs ( n =226) or ISDs ( n =228) between 2003 and 2013 that were reported to the Chinese Bone Marrow Transplantation Registry were analyzed. Among the 3/6 HID ( n =136), 4–5/6 HID ( n =90) and ISD patient groups, the 4-year adjusted cumulative incidences of non-relapse mortality were 34, 29 and 16%, respectively (overall P =0.004), and of relapse were 6, 7 and 10%, respectively (overall P =0.36). The 4-year adjusted probabilities of overall survival were 58, 63 and 73%, respectively (overall P =0.07), and of relapse-free-survival were 58, 63 and 71%, respectively (overall P =0.14); pairwise comparison showed that the difference was only statistically significant in the 3/6 HID vs ISD pair. The data suggest that ISDs remain the best donor source for MDS patients while HIDs (perhaps 4–5/6 HID in particular) could be a valid alternative when an ISD is not available; human leukocyte antigen disparity had no effect on survival among the HID patients.