Comparison of HLA-mismatched unrelated donor transplantation with post-transplant cyclophosphamide versus HLA-haploidentical transplantation in patients with active acute myeloid leukemia

Baron F, Labopin M, Tischer J, Ciceri F, Raiola AM, Blaise D, Sica S, Vydra J, Fanin R, Diez-Martin JL, Bulabois CE, Stolzel F, Busca A, Jindra P, Koc Y, Chevallier P, Forcade E, Rösler W, Passweg J, Kulagin A, Carella AM, Simand C, Bazarbachi A, Pioltelli P, Nagler A, Mohty M (2022)

Publication Type: Journal article

Publication year: 2022

Journal

DOI: 10.1038/s41409-022-01781-9

Abstract

HLA-haploidentical allogeneic hematopoietic stem cell transplantation (Haplo-HCT) is frequently used as treatment for patients with active acute myeloid leukemia (AML). Here, we investigated whether 9/10 HLA-mismatched unrelated donor transplantation (MMUD-HCT) with post-transplant cyclophosphamide (PTCy) is an adequate alternative. Inclusion criteria in this retrospective registry study consisted of adult patients, first HCT with a Haplo donor or MMUD between 2010 and 2020 using PTCy as graft-versus-host disease (GVHD) prophylaxis, and primary refractory or relapsed disease. MMUD patients were pair-matched 1 to 2 with Haplo-recipients. A total of 73 MMUD patients met the inclusion criteria. Their data were compared to those of 146 Haplo patients in a matched-pair analysis. Median follow-up was 27 months in MMUD patients and 36 months in Haplo recipients. Two-year incidences of relapse and non-relapse mortality (NRM) were 40% and 18% in MMUD patients, respectively, versus 50% (P = 0.23) and 24% (P = 0.18) in Haplo recipients. Two-year leukemia-free survival (LFS) and overall survival (OS) was 42% and 46% in MMUD recipients, respectively, versus 26% (P = 0.1) and 28% (P = 0.061) in Haplo-patients. In conclusions, in AML patients with active disease at transplantation, MMUD-HCT results in at least comparable outcomes to Haplo-HCT when PTCy is applied.

Authors with CRIS profile

Involved external institutions

University of Liège (ULg) / Université de Liège Belgium (BE) Ludwig-Maximilians-Universität (LMU) Germany (DE) Università Vita-Salute San Raffaele (UniSR) Italy (IT) Ospedale San Martino (IRCCS AOU) Italy (IT) Aix-Marseille University / Aix-Marseille Université France (FR) Fondazione Policlinico Universitario Agostino Gemelli IRCCS Italy (IT) Institute of Hematology and Blood Transfusion (IHBT) / Ústav hematologie a krevní transfuze (ÚHKT) Czech Republic (CZ) University Hospital of Udine Italy (IT) Universidad Complutense de Madrid (UCM) Spain (ES) University of Grenoble Alpes (UGA) / Université de Grenoble France (FR) Technische Universität Dresden Germany (DE) Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino Italy (IT) General University Hospital in Prague / Všeobecná Fakultní Nemocnice v Praze (VFN) Czech Republic (CZ) Medicana International Istanbul Hospital Turkey (TR) Nantes University Hospital / Centre hospitalier universitaire de Nantes (CHU) France (FR) Centre Hospitalier Universitaire de Bordeaux / CHU Bordeaux France (FR) Universitätsspital Basel Switzerland (CH) First Pavlov State Medical University of St. Petersburg Russian Federation (RU) Casa Sollievo della Sofferenza Italy (IT) Hôpitaux universitaires de Strasbourg (HUS) / University Hospital Strasbourg France (FR) American University of Beirut (AUB) / الجامعة الأميركية في بيروت‎‎ Lebanon (LB) University of Milano-Bicocca / Università degli Studi di Milano-Bicocca, UNIMIB Italy (IT) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL)

How to cite

APA:

Baron, F., Labopin, M., Tischer, J., Ciceri, F., Raiola, A.M., Blaise, D.,... Mohty, M. (2022). Comparison of HLA-mismatched unrelated donor transplantation with post-transplant cyclophosphamide versus HLA-haploidentical transplantation in patients with active acute myeloid leukemia. Bone Marrow Transplantation. https://doi.org/10.1038/s41409-022-01781-9

MLA:

Baron, Frederic, et al. "Comparison of HLA-mismatched unrelated donor transplantation with post-transplant cyclophosphamide versus HLA-haploidentical transplantation in patients with active acute myeloid leukemia." Bone Marrow Transplantation (2022).

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