Skip to main navigation Skip to search Skip to main content

Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia

  • Matthew J. Wieduwilt
  • , Leland Metheny
  • , Mei Jie Zhang
  • , Hai Lin Wang
  • , Noel Estrada-Merly
  • , David I. Marks
  • , A. Samer Al-Homsi
  • , Lori Muffly
  • , Nelson Chao
  • , David Rizzieri
  • , Robert Peter Gale
  • , Shahinaz M. Gadalla
  • , Mitchell Cairo
  • , Alberto Mussetti
  • , Steven Gore
  • , Vijaya Raj Bhatt
  • , Sagar S. Patel
  • , Fotios V. Michelis
  • , Yoshihiro Inamoto
  • , Sherif M. Badawy
  • Edward Copelan, Neil Palmisiano, Mohamed A. Kharfan-Dabaja, Hillard M. Lazarus, Siddhartha Ganguly, Christopher Bredeson, Miguel Angel Diaz Perez, Ryan Cassaday, Bipin N. Savani, Karen Ballen, Rodrigo Martino, Baldeep Wirk, Ulrike Bacher, Mahmoud Aljurf, Asad Bashey, Hemant S. Murthy, Jean A. Yared, Ibrahim Aldoss, Nosha Farhadfar, Hongtao Liu, Hisham Abdel-Azim, Edmund K. Waller, Melhem Solh, Matthew D. Seftel, Marjolein van der Poel, Michael R. Grunwald, Jane L. Liesveld, Rammurti T. Kamble, Joseph McGuirk, Reinhold Munker, Jean Yves Cahn, Jong Wook Lee, Cesar O. Freytes, Maxwell M. Krem, Lena E. Winestone, Usama Gergis, Sunita Nathan, Richard F. Olsson, Leo F. Verdonck, Akshay Sharma, Olle Ringden, Brian D. Friend, Jan Cerny, Hannah Choe, Saurabh Chhabra, Taiga Nishihori, Sachiko Seo, Biju George, Lee Ann Baxter-Lowe, Gerhard C. Hildebrandt, Marcos de Lima, Mark Litzow, Partow Kebriaei, Christopher S. Hourigan, Muhammad Bilal Abid, Daniel J. Weisdorf, Wael Saber

Research output: Contribution to journal › Article › peer-review

Abstract

The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

Original languageEnglish (US)
Pages (from-to)339-357
Number of pages19
JournalBlood Advances
Volume6
Issue number1
DOIs
StatePublished - Jan 11 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • Fetal Blood
  • Hematopoietic Stem Cell Transplantation/adverse effects
  • Humans
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy
  • Retrospective Studies
  • Siblings
  • Unrelated Donors

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Journal Article
  • Research Support, N.I.H., Extramural

Fingerprint

Dive into the research topics of 'Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia'. Together they form a unique fingerprint.

Cite this