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 journalArticlepeer-review

179 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)1975-1981
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Acute myeloid leukemia
  • Fludarabine-melphalan
  • Haploidentical transplantation
  • Hematopoietic stem cell transplantation
  • Myeloablative reduced-intensity conditioning regimen
  • Myelodysplastic syndromes
  • Post-transplantation cyclophosphamide

ASJC Scopus subject areas

  • Hematology
  • Transplantation

MD Anderson CCSG core facilities

  • Biostatistics Resource Group

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