Abstract
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.
Original language | English (US) |
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Pages (from-to) | 1975-81 |
Number of pages | 7 |
Journal | Biology of Blood and Marrow Transplantation |
Volume | 20 |
Issue number | 12 |
DOIs | |
State | Published - Dec 2014 |
Keywords
- Adult
- Aged
- Allografts
- Disease-Free Survival
- Female
- HLA Antigens
- Histocompatibility Testing
- Humans
- Leukemia, Myeloid, Acute
- Male
- Middle Aged
- Myelodysplastic Syndromes
- Retrospective Studies
- Stem Cell Transplantation
- Survival Rate
- Unrelated Donors
- Clinical Trial
- Comparative Study
- Journal Article