Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission Journal Article

Authors: Rashidi, A.; Hamadani, M.; Zhang, M. J.; Wang, H. L.; Abdel-Azim, H.; Aljurf, M.; Assal, A.; Bajel, A.; Bashey, A.; Battiwalla, M.; Beitinjaneh, A. M.; Bejanyan, N.; Bhatt, V. R.; Bolaños-Meade, J.; Byrne, M.; Cahn, J. Y.; Cairo, M.; Ciurea, S.; Copelan, E.; Cutler, C.; Daly, A.; Diaz, M. A.; Farhadfar, N.; Gale, R. P.; Ganguly, S.; Grunwald, M. R.; Hahn, T.; Hashmi, S.; Hildebrandt, G. C.; Kent Holland, H.; Hossain, N.; Kanakry, C. G.; Kharfan-Dabaja, M. A.; Khera, N.; Koc, Y.; Lazarus, H. M.; Lee, J. W.; Maertens, J.; Martino, R.; McGuirk, J.; Munker, R.; Murthy, H. S.; Nakamura, R.; Nathan, S.; Nishihori, T.; Palmisiano, N.; Patel, S.; Pidala, J.; Olin, R.; Olsson, R. F.; Oran, B.; Ringden, O.; Rizzieri, D.; Rowe, J.; Savoie, M. L.; Schultz, K. R.; Seo, S.; Shaffer, B. C.; Singh, A.; Solh, M.; Stockerl-Goldstein, K.; Verdonck, L. F.; Wagner, J.; Waller, E. K.; De Lima, M.; Sandmaier, B. M.; Litzow, M.; Weisdorf, D.; Romee, R.; Saber, W.
Article Title: Outcomes of haploidentical vs matched sibling transplantation for acute myeloid leukemia in first complete remission
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 5 .15), leukemia-free survival (P 5 .50), nonrelapse mortality (P 5 .16), relapse (P 5 .90), or grade II-IV acute GVHD (P 5 .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. © 2019 American Society of Hematology. All rights reserved.
Journal Title: Blood Advances
Volume: 3
Issue: 12
ISSN: 2473-9529
Publisher: American Society of Hematology  
Date Published: 2019-06-25
Start Page: 1826
End Page: 1836
Language: English
DOI: 10.1182/bloodadvances.2019000050
PUBMED: 31201170
PROVIDER: scopus
PMCID: PMC6595262
Notes: Source: Scopus
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MSK Authors
  1. Brian Carl Shaffer
    47 Shaffer