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Similar Transplantation Outcomes for Acute Myeloid Leukemia and Myelodysplastic Syndrome Patients with Haploidentical versus 10/10 Human Leukocyte Antigen–Matched Unrelated and Related Donors

2014; Elsevier BV; Volume: 20; Issue: 12 Linguagem: Inglês

10.1016/j.bbmt.2014.08.013

1523-6536

Antonio Di Stasi, Denái R. Milton, Li Mei Poon, Amir Hamdi, Gabriela Rondón, Julianne Chen, Sai Ravi Pingali, Marina Konopleva, Piyanuch Kongtim, Amin M. Alousi, Muzaffar H. Qazilbash, Sairah Ahmed, Qaiser Bashir, Gheath Alatrash, Betül Oran, Chitra Hosing, Partow Kebriaei, Uday Popat, Elizabeth J. Shpall, Dean A. Lee, Marcos de Lima, Katayoun Rezvani, Issa F. Khouri, Richard E. Champlin, Stefan O. Ciurea,

Acute Myeloid Leukemia Research

Allogeneic stem cell transplantation for patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) has been performed primarily with an HLA-matched donor. Outcomes of haploidentical transplantation have recently improved, and a comparison between donor sources in a uniform cohort of patients has not been performed. We evaluated outcomes of 227 patients with AML/MDS treated with melphalan-based conditioning. Donors were matched related (MRD) (n = 87, 38%), matched unrelated (MUD) (n = 108, 48%), or haploidentical (n = 32, 14%). No significant differences were found between haploidentical and MUD transplantation outcomes; however, there was a trend for improved outcomes in the MRD group, with 3-year progression-free survival for patients in remission of 57%, 45%, and 41% for MRD, MUD, and haploidentical recipients, respectively (P = .417). Recovery of T cell subsets was similar for all groups. These results suggest that haploidentical donors can safely extend transplantation for AML/MDS patients without an HLA-matched donor. Prospective studies comparing haploidentical and MUD transplantation are warranted.