Haploidentical and matched unrelated donor allogeneic hematopoietic stem cell transplantation offer similar survival outcomes for acute leukemia

Abstract

BackgroundHaploidentical hematopoietic stem cell transplantation (haplo‐HSCT) has emerged as an effective approach for acute leukemia, primarily due to the inherent difficulty in finding human leukocyte antigen‐matched unrelated donors (MUD). Nevertheless, it remains uncertain whether haplo‐HSCT and MUD‐HSCT can provide comparable outcomes in patients with acute leukemia.AimsThis study aimed to assess the overall survival (OS) and leukemia‐free survival (LFS) outcomes between the MUD‐HSCT and haplo‐HSCT groups.Methods and resultsThis retrospective analysis encompassed adult patients with acute leukemia undergoing the initial allo‐HSCT. Among these 85 patients, we stratified 33 patients into the MUD‐HSCT group and 52 to the haplo‐HSCT group. The primary outcomes were OS and LFS. The median OS was not reached in the haplo‐HSCT group, while it reached 29.8 months in patients undergoing MUD‐HSCT (p = .211). Likewise, the median LFS periods were 52.6 months in the haplo‐HSCT group and 12.7 months in the MUD‐HSCT group (p = .212). Importantly, neither the OS nor LFS showed substantial differences between the MUD‐HSCT and haplo‐HSCT groups. Furthermore, univariate analyses revealed that haplo‐HSCT did not demonstrate a significantly higher risk of worse LFS (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.38–1.25; p = .216) or OS (HR, 0.67; 95% CI, 0.36–1.26; p = .214) than MUD‐HSCT. Notably, a high European Group for Blood and Marrow Transplantation risk score (HR, 1.44; 95% CI, 1.10–1.87; p = .007) and non‐complete remission (HR, 2.48; 95% CI, 1.17–5.23; p = .017) were significantly correlated with worse OS.ConclusionHaplo‐HSCT may serve as an alternative to MUD‐HSCT for the treatment of acute leukemia, offering similar survival outcomes.