Similar transplantation outcomes for acute myeloid leukemia and myelodysplastic syndrome patients with haploidentical versus 10/10 human leukocyte antigen-matched unrelated and related donors

Antonio Di Stasi, Denái R Milton, L M Poon, Amir Hamdi, Gabriela Rondon, Julianne Chen, Sai R Pingali, Marina Konopleva, Piyanuch Kongtim, Amin Alousi, Muzaffar H Qazilbash, Sairah Ahmed, Qaiser Bashir, Gheath Al-atrash, Betul Oran, Chitra M Hosing, Partow Kebriaei, Uday Popat, Elizabeth J Shpall, Dean A LeeMarcos de Lima, Katayoun Rezvani, Issa F Khouri, Richard E Champlin, Stefan O Ciurea

Research output: Contribution to journalArticle

144 Scopus citations

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 languageEnglish (US)
Pages (from-to)1975-81
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number12
DOIs
StatePublished - 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

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