Citations 1
Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission
Rashidi, Armin , Hamadani, Mehdi , Zhang, Mei-Jie , Wang, Hai-Lin, Abdel‐Azim, Hisham , Aljurf, Mahmoud , Assal, Amer , Bashey, Asad, Beitinjaneh, Amer , Bejanyan, Nelli , Bolaños‐Meade, Javier , Byrne, Michael , Cahn, Jean‐Yves, Cairo, Mitchell S. , Ciurea, Stefan O. , Copelan, Edward A. , Daly, Andrew , Diaz, Miguel-Angel, Farhadfar, Nosha , Ganguly, Siddhartha , Hahn, Theresa , Hashmi, Shahrukh K. , Hildebrandt, Gerhard , Holland, H. Kent, Hossain, Nasheed , Kanakry, Christopher G. , Kharfan‐Dabaja, Mohamed A. , Khera, Nandita , Martino, Rodrigo , Munker, Reinhold , Murthy, Hemant S. , Nakamura, Ryotaro , Nathan, Sunita , Palmisiano, Neil , Patel, Sagar S. , Pidala, Joseph, Olin, Rebecca L. , Olsson, Richard F. , Ringdén, Olle , Rizzieri, David A. , Rowe, Jacob M. , Savoie, Mary Lynn , Seo, Sachiko , Shaffer, Brian C. , Singh, Anurag K. , Solh, Melhem , Stockerl‐Goldstein, Keith , Verdonck, Leo F. , Wagner, John L. , Waller, Edmund K. , Litzow, Mark R. , Weisdorf, Dan, Saber, Wael , Weisdorf, Daniel J. , Wagner, John E. , Gale, Robert P , Hashmi, Shahrukh K , Hildebrandt, Gerhard C , Kharfan-Dabaja, Mohamed A., McGuirk, Joseph , Murthy, Hemant S , Nishihori, Taiga , Patel, Sagar , Olsson, Richard F , Ringden, Olov , Savoie, Mary Lynn , Wagner, John , Waller, Edmund K , Sandmaier, Brenda M , Litzow, Mark R. , Weisdorf, Dan , Hamadani, Mehdi , Assal, Amer , Martino, Rodrigo , Zhang, Mei‐Jie , Bajel, Ashish R. , Battiwalla, Minoo , Bhatt, Vijaya Raj , Cahn, Jean‐Yves , Cutler, Corey S. , Gale, Robert Peter , Grunwald, Michael R. , Koç, Yener , Lazarus, Hillard M. , Lee, Jong Wook , Maertens, Johan A. , McGuirk, Joseph P. , Nishihori, Taiga , Oran, Betül , Schultz, Kirk R. , Lima, Marcos de , Romee, Rizwan , Rashidi, Armin , Stockerl-Goldstein, Keith
Blood Advances | June 14, 2019 | Volume: 3 | Issue: 12 | Pages: 1826-1836
10.1182/bloodadvances.2019000050
Abstract HLA-haploidentical hematopoietic cell transplantation (Haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) has improved donor availability. However, a matched sibling donor (MSD) is still considered the optimal donor. Using the Center for International Blood and Marrow Transplant Research database, we compared outcomes after Haplo-HCT vs MSD in patients with acute myeloid leukemia (AML) in first complete remission (CR1). Data from 1205 adult CR1 AML patients (2008-2015) were analyzed. A total of 336 patients underwent PT-Cy–based Haplo-HCT and 869 underwent MSD using calcineurin inhibitor–based graft-versus-host disease (GVHD) prophylaxis. The Haplo-HCT group included more reduced-intensity conditioning (65% vs 30%) and bone marrow grafts (62% vs 7%), consistent with current practice. In multivariable analysis, Haplo-HCT and MSD groups were not different with regard to overall survival (P = .15), leukemia-free survival (P = .50), nonrelapse mortality (P = .16), relapse (P = .90), or grade II-IV acute GVHD (P = .98). However, the Haplo-HCT group had a significantly lower rate of chronic GVHD (hazard ratio, 0.38; 95% confidence interval, 0.30-0.48; P < .001). Results of subgroup analyses by conditioning intensity and graft source suggested that the reduced incidence of chronic GVHD in Haplo-HCT is not limited to a specific graft source or conditioning intensity. Center effect and minimal residual disease–donor type interaction were not predictors of outcome. Our results indicate a lower rate of chronic GVHD after PT-Cy–based Haplo-HCT vs MSD using calcineurin inhibitor–based GVHD prophylaxis, but similar other outcomes, in patients with AML in CR1. Haplo-HCT is a viable alternative to MSD in these patients.