Comparable outcomes of haploidentical, 10/10 and 9/10 unrelated donor transplantation in adverse karyotype AML in first complete remission.

Allogeneic hematopoietic stem cell transplantation (HSCT) is the most powerful therapy preventing relapse in patients with adverse cytogenetics acute myeloid leukemia (AML) in first complete remission (CR1). In the absence of a matched related donor, potential alternatives include 10/10, 9/10 HLA-matched unrelated (UD) or haploidentical (Haplo) donors. We analyzed clinical outcomes of patients undergoing T-cell repleted Haplo (n = 74), 10/10 UD (n = 433) and 9/10 UD HSCT (n = 123) from 2007 to 2015, reported to the EBMT Registry. Adverse risk AML was defined according to the 2017 ELN cytogenetic risk classification. The 2-year nonrelapse mortality was 19% for Haplo, 18% for 10/10 UD and 18% for 9/10 UD (P = .9). The relapse incidence was not significantly affected by donor source, with a 2-year incidence of 27% for Haplo HSCT, 39% for 10/10 UD and 37% for 9/10 UD SCT (P = .3). We show comparable probabilities of leukemia-free survival (LFS) and overall survival (OS) at 2 years among Haplo HSCT, 10/10 UD SCT and 9/10 UD SCT (53% and 59%, 43% and 50%, 44% and 50%, respectively, P = .5 for both parameters). The type of donor was not significantly associated with either acute or chronic graft-vs.-host disease incidence. Using multivariable Cox model, Haplo HSCT recipients experienced comparable OS and LFS to 10/10 and 9/10 UD. In the present series of adverse cytogenetics AML patients in CR1, Haplo HSCT recipients had comparable outcomes to those of 10/10 and 9/10 UDs, suggesting that all these types of HSCT may be considered a valid option in this high risk population.

Lorentino F ，Labopin M ，Bernardi M ，Ciceri F ，Socié G ，Cornelissen JJ ，Esteve J ，Ruggeri A ，Volin L ，Yacoub-Agha I ，Craddock C ，Passweg J ，Blaise D ，Gedde-Dahl T ，Poiani M ，Fegueux N ，Mohty M ，Nagler A ，Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation ... -  《-》

Comparable outcome after haploidentical and HLA-matched allogeneic stem cell transplantation for high-risk acute myeloid leukemia following sequential conditioning-a matched pair analysis.

Doppelhammer M ，Fraccaroli A ，Prevalsek D ，Bücklein V ，Häbe S ，Schulz C ，Hubmann M ，Hausmann A ，Claus R ，Rank A ，Schmid C ，Tischer J ... -  《-》

A comparison between allogeneic stem cell transplantation from unmanipulated haploidentical and unrelated donors in acute leukemia.

Piemontese S ，Ciceri F ，Labopin M ，Arcese W ，Kyrcz-Krzemien S ，Santarone S ，Huang H ，Beelen D ，Gorin NC ，Craddock C ，Gulbas Z ，Bacigalupo A ，Mohty M ，Nagler A ，Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) ... -  《Journal of Hematology & Oncology》

Matched and mismatched unrelated donor compared to autologous stem cell transplantation for acute myeloid leukemia in first complete remission: a retrospective, propensity score-weighted analysis from the ALWP of the EBMT.

Saraceni F ，Labopin M ，Gorin NC ，Blaise D ，Tabrizi R ，Volin L ，Cornelissen J ，Cahn JY ，Chevallier P ，Craddock C ，Wu D ，Huynh A ，Arcese W ，Mohty M ，Nagler A ，Acute Leukemia Working Party (ALWP) of the European society for Blood and Marrow Transplantation (EBMT) ... -  《Journal of Hematology & Oncology》

Myeloablative Haploidentical Transplantation Is Superior to Chemotherapy for Patients with Intermediate-risk Acute Myelogenous Leukemia in First Complete Remission.

Although myeloablative HLA haploidentical hematopoietic stem cell transplantation (haplo-HSCT) following pretransplant anti-thymocyte globulin (ATG) and granulocyte colony-stimulating factor (G-CSF) stimulated grafts (ATG+G-CSF) has been confirmed as an alternative to HSCT from HLA-matched sibling donors (MSD), the effect of haplo-HSCT on postremission treatment of patients with acute myeloid leukemia (AML) with intermediate risk (int-risk AML) who achieved first complete remission (CR1) has not been defined. In this prospective trial, among 443 consecutive patients ages 16-60 years with newly diagnosed de novo AML with int-risk cytogenetics, 147 patients with molecular int-risk AML who achieved CR1 within two courses of induction and remained in CR1 at 4 months postremission either received chemotherapy (n = 69) or underwent haplo-HSCT (n = 78). The 3-year leukemia-free survival (LFS) and overall survival (OS) were significantly higher in the haplo-HSCT group than in the chemotherapy group (74.3% vs. 47.3%; P = 0.0004 and 80.8% vs. 53.5%; P = 0.0001, respectively). In the multivariate analysis with propensity score adjustment, postremission treatment (haplo-HSCT vs. chemotherapy) was an independent risk factor affecting the LFS [HR 0.360; 95% confidence interval (CI), 0.163-0.793; P = 0.011], OS (HR 0.361; 95% CI, 0.156-0.832; P = 0.017), and cumulative incidence of relapse (HR 0.161; 95% CI, 0.057-0.459; P = 0.001) either in entire cohort or stratified by minimal residual disease after the second consolidation. Myeloablative haplo-HSCT with ATG+G-CSF is superior to chemotherapy as a postremission treatment in patients with int-risk AML during CR1. Haplo-HSCT might be a first-line postremission therapy for int-risk AML in the absence of HLA-MSDs. Haplo-HSCT might be superior to chemotherapy as a first-line postremission treatment of intermediate-risk AML in CR1.

Lv M ，Wang Y ，Chang YJ ，Zhang XH ，Xu LP ，Jiang Q ，Jiang H ，Lu J ，Chen H ，Han W ，Wang FR ，Wang JZ ，Chen Y ，Yan CH ，Zhang YY ，Sun YQ ，Mo XD ，Zhu HH ，Jia JS ，Zhao T ，Wang J ，Liu KY ，Huang XJ ... -  《-》