Haploidentical Versus Matched Sibling Donor Hematopoietic Stem Cell Transplantation for Adult Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia: A Study From the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Arnon Nagler,
Myriam Labopin,
Ryszard Swoboda,
Pietro Pioltelli,
Mutlu Arat,
Ibrahim Yakoub-Agha,
Alexander Kulagin,
Anna Maria Raiola,
Hakan Ozdogu,
Antonio Risitano,
Zubeyde Nur Ozkurt,
Jaime Sanz,
Eolia Brissot,
Peric Zina,
Sebastian Giebel,
Fabio Ciceri,
Mohamad Mohty
Affiliations
Arnon Nagler
1 Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel
Myriam Labopin
2 ALWP of the EBMT Paris Office, France
Ryszard Swoboda
4 Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
Pietro Pioltelli
5 Ospedale San Gerardo, Clinica Ematologica dell`Universita Milano-Biocca, Monza, Italy
Mutlu Arat
6 Hematopoietic SCT Unit, Demiroglu Bilim University Istanbul Florence Nightingale Hospital, Istanbul, Turkey
Ibrahim Yakoub-Agha
7 CHU de Lille LIRIC, INSERM U995, Université de Lille, Lille, France
Alexander Kulagin
8 RM Gorbacheva Research Institute, Pavlov University, St Petersburg, Russia
Anna Maria Raiola
9 Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico, San Martino, Genova, Italy
Hakan Ozdogu
10 Haematology Division, BMT Unit, Baskent University Hospital, Hematology Research Laboratory, Training & Medical, Adana, Turkey
12 Gazi University Faculty of Medicine, Hematology, Ankara, Turkey
Jaime Sanz
13 Hospital Universitari i Politècnic La Fe, Valencia, Spain
Eolia Brissot
14 Service d’Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Sorbonne Université, INSERM UMRs 938, Paris, France
Peric Zina
15 School of Medicine, University Hospital Centre Zagreb, University of Zagreb, Croatia
Sebastian Giebel
4 Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
Fabio Ciceri
16 Ospedale San Raffaele s.r.l. Hematology and BMT, Milano, Italy
Mohamad Mohty
17 Department of Hematology, Hospital Saint Antoine, EBMT Paris Study Office/CREST-TC, Saint Antoine Hospital, Paris, France
The results of haploidentical stem cell transplantation (haploHCT) for patients with acute lymphoblastic leukemia (ALL) transplanted in active disease remain largely unknown. We retrospectively analyzed adult patients with R/R ALL who underwent haploHCT or matched sibling donor (MSD-HCT) as a first transplantation between 2012 and 2020. The analysis comprised 274 patients, 94 had a haploHCT, and 180 had an MSD-HCT. The median follow-up was 32 months. The median age was 33 (range 18–76) and 37 (18–76) years in the haplo- and MSD-HCT groups, respectively. Post-transplant cyclophosphamide (PTCy) was used in 88% of haploHCT and in 4% of the MSD-HCT group. Graft-versus-host disease grade III–IV was higher in haploHCT than in the MSD-HCT group (18% versus 9%; P = 0.042). The 2-year chronic (c) graft-versus-host disease rates were 17% versus 33% (hazard ratio [HR] = 0.56; P = 0.14), respectively. By multivariate analysis, relapse incidence, and leukemia-free survival were not significatively different between the transplant groups, while nonrelapse mortality (NRM) was significantly higher (25% versus 18% at 2 years; HR = 2.03; P = 0.042) and overall survival (OS) lower (22% versus 38% at 2 years; HR = 1.72; P = 0.009) in the haploHCT group compared with the MSD-HCT group. We conclude that the 2-year OS of R/R ALL patients undergoing MSD transplants is significantly better than in haploHCT with a higher NRM in the latter.
