Haploidentical transplantation compared with matched siblingￂ 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; p. 120
• 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: Oxford Blackwell Publishing Ltd 01.10.2017
• Subjects: Acute lymphoblastic leukemia; Graft-versus-host reaction; Hematology; Histocompatibility antigen HLA; Leukemia; Mud; Remission; Survival; Transplantation; Transplants & implants
• 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.