Lower relapse incidence with haploidentical versus matched sibling or unrelated donor hematopoietic cell transplantation for core‐binding factor AML patients in CR2: A study from the Global Committee and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Author:

Ye Yishan1ORCID,Labopin Myriam2,Gérard Socié3,Yakoub‐Agha Ibrahim4,Blau Igor Wolfgang5,Aljurf Mahmoud6,Forcade Edouard7,Gedde‐Dahl Tobias8,Burns David9,Vydra Jan10,Halahleh Khalid11,Hamladji Rose‐Marie12,Bazarbachi Ali13ORCID,Nagler Arnon14,Brissot Eolia215,Li Lin1ORCID,Luo Yi1,Zhao Yanmin1,Ciceri Fabio16,Huang He1,Mohty Mohamad215,Gorin Norbert Claude215ORCID

Affiliation:

1. Bone Marrow Transplantation Center The First Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China

2. EBMT Paris Study Office, Hôpital Saint Antoine 184 Paris Cedex 12 France

3. Saint‐Louis Hospital, BMT Unit Paris France

4. CHU de Lille, Univ de Lille, INSERM U1286 Lille France

5. Department of Hematology Charité‐Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt Universität zu Berlin Berlin Germany

6. King Faisal Specialist Hospital & Research Centre Riyadh Saudi Arabia

7. CHU Bordeaux, Hopital Haut‐Leveque Bordeaux France

8. Oslo University Hospital, Rikshospitalet Oslo Norway

9. University Hospital Birmingham NHSTrust Birmingham UK

10. Institute of Hematology and Blood Transfusion Prague Czech Republic

11. King Hussein Cancer Centre Adult BMT Program Amman Jordan

12. Centre Pierre et Marie Curie Alger Algeria

13. Bone Marrow Transplantation Program, Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon

14. Department of Bone Marrow Transplantation Chaim Sheba Medical Center Tel‐Hashomer Israel

15. Department of Hematology and Cell therapy Hospital Saint‐Antoine, Sorbonne University Paris France

16. Ospedale San Raffaele s.r.l., Haematology and BMT Milano Italy

Abstract

AbstractAllogeneic hematopoietic cell transplantation (allo‐HCT) is recommended for core‐binding factor mutated (CBF) AML patients achieving second complete remission (CR2). However, approximately 20% of patients may relapse after transplant and donor preference remains unclear. We compared in this EBMT global multicenter registry‐based analysis the allo‐HCT outcomes using either haploidentical (Haplo), matched siblings donors (MSD), or 10/10 matched unrelated donors (MUD). Data from 865 de novo adult CBF AML patients in CR2 receiving allo‐HCT in 227 EBMT centers from 2010 to 2022 were analyzed, in which 329 MSD, 374 MUD, and 162 Haplo‐HCTs were included. For the entire cohort, 503 (58%) patients were inv(16)/CBFB‐MYH11 and 362 patients (42%) were t(8;21)/RUNX1‐RUNX1T1 AML. On multivariate analysis, Haplo‐HCT was associated with a lower Relapse Incidence (RI) compared to either MSD (hazard ratio [HR] = 0.56, 95% CI 0.32–0.97; p < .05) or MUD (HR = 0.57, 95% CI: 0.33–0.99, p < .05). No significant difference was observed among the 3 types of donors on LFS, OS and GRFS. CBF‐AML with t(8;21) was associated with both higher RI (HR = 1.79, 95% CI 1.3–2.47; p < .01) and higher NRM (HR = 1.58, 95% CI 1.1–2.27; p < .01) than CBF‐AML with inv(16), which led to worse LFS, OS and GRFS. To conclude, for CBF‐AML patients in CR2, Haplo‐HCTs were associated with a lower RI compared to MSD and MUD allo‐HCTs. There was no difference on LFS, OS or GRFS. CBF AML patients with inv(16) had a better progonosis than those with t(8;21) after allo‐HCT in CR2.

Funder

National Natural Science Foundation of China

Medical Science and Technology Project of Zhejiang Province

Publisher

Wiley

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