Haploidentical related donor vs matched sibling donor allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia and myelodysplastic syndrome aged over 50 years: A single‐center retrospective study

Abstract

Allogeneic hematopoietic stem cell transplantation (allo‐HSCT) is a potentially curative therapeutic option for patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). Increasing data suggest that haploidentical donor (HID) transplantation achieve comparable outcomes with HLA‐matched sibling donor (MSD) in adult AML/MDS. This retrospective study compared the outcomes of AML or MDS patients age ≥50 years underwent HID and MSD transplantation. One hundred and fifty‐six patients were enrolled in this study, including 75 HID and 81 MSD transplantation. The 100‐day cumulative incidence of II‐IV° acute graft‐versus‐host disease (GVHD) was 33.3 ± 5.4% vs 22.2 ± 4.6%, respectively, in HID and MSD groups (P = .066), and III‐IV° acute GVHD was not significantly different between two groups (5.3%±2.6% vs 6.2%±2.7%, respectively, P = .823). The 2‐year cumulative incidence of limited and extensive chronic GVHD was not statistically different in HID and MSD groups (20.9 ± 5.5% vs 18.9 ± 4.8% and 13.0 ± 4.7% vs 19.7 ± 5.0%, P = .889 and P = .269, respectively). The 2‐year cumulative incidences of relapse (27.0 ± 5.6% vs 22.7 ± 5.1%, P = .509), 2‐year overall survival (63.0 ± 5.8% vs 66.7 ± 5.4%, P = .454), 2‐year transplant‐related mortality (17.2 ± 4.6% vs 17.4 ± 4.4%, P = .847), 2‐year progression‐free survival (59.3 ± 5.8% vs 64.5 ± 5.4%, P = .437), 2‐year GVHD‐free relapse‐free survival (42.6 ± 5.9% vs 40.9 ± 5.6%, P = .964) were not significantly different in the two groups. The present data showed equivalent outcomes in AML or MDS patients age ≥50 years underwent HID and MSD transplantation.

CMV Infection and CMV-Specific Immune Reconstitution Following Haploidentical Stem Cell Transplantation: An Update

“…Consistently, several centers in China obtained similar results for SAA patients (13)(14)(15). The haploSCT cohorts with AML, MDS, or Ph+ ALL, including haplo-cord-HSCT, had higher CMV viremia than the HLA-matched HSCT cohorts (16)(17)(18)(19), but the incidence of CMV disease was not significantly different between the two groups. Even in pediatric patients with MDS or patients with relapsed/ refractory acute lymphoblastic leukemia after CAR-T therapy who underwent haploSCT, the incidence of CMV reactivation/ infection was less than 60%, and very few patients developed CMV disease (20,21).…”

A Prospective Trial Comparing Haploidentical Donor Transplantation With Cord Blood Versus HLA-Matched Sibling Donor Transplantation for Hematologic Malignancy Patients

“…It has been shown that the incidence of infection after HID HSCT is higher than HLA-matched transplantation due to the delayed immunologic reconstitution 23,24 . It is especially apparent in HID transplantation with ATG-based regimens 25 .…”

Haploidentical transplants deliver equal outcomes to matched sibling transplants: a propensity score-matched analysis

“…A fresh analysis conducted by the Chronic Malignancies Working Party of European Society for Blood and Marrow Transplantation suggested that the MSD remains the preferred choice over the HID in myelodysplastic syndromes, despite the baseline older donor age of 55 years in MSD than 36 years in HID [ 19 ]. A single-center study with significant inequivalent donor age showed similar outcomes achieved in HID and MSD groups [ 20 ]. Large variations of outcomes from several studies can be brought on because of baseline imbalances.…”