Haploidentical and matched unrelated donor allogeneic hematopoietic stem cell transplantation offer similar survival outcomes for acute leukemia

Author:

Wang Yin‐Che1,Lai Cheng‐Lun1,Chen Tsung‐Chih12,Gau Jyh‐Pyng3,Teng Chieh‐Lin Jerry12456ORCID

Affiliation:

1. Division of Hematology/Medical Oncology, Department of Medicine Taichung Veterans General Hospital Taichung Taiwan

2. Department of Post‐Baccalaureate Medicine, College of Medicine National Chung Hsing University Taichung Taiwan

3. Division of Hematology and Oncology, Department of Medicine Taipei Medical University Hospital

4. Ph.D. Program in Translational Medicine National Chung Hsing University Taichung Taiwan

5. Rong Hsing Research Center for Translational Medicine National Chung Hsing University Taichung Taiwan

6. School of Medicine Chung Shan Medical University Taichung Taiwan

Abstract

AbstractBackgroundHaploidentical hematopoietic stem cell transplantation (haplo‐HSCT) has emerged as an effective approach for acute leukemia, primarily due to the inherent difficulty in finding human leukocyte antigen‐matched unrelated donors (MUD). Nevertheless, it remains uncertain whether haplo‐HSCT and MUD‐HSCT can provide comparable outcomes in patients with acute leukemia.AimsThis study aimed to assess the overall survival (OS) and leukemia‐free survival (LFS) outcomes between the MUD‐HSCT and haplo‐HSCT groups.Methods and resultsThis retrospective analysis encompassed adult patients with acute leukemia undergoing the initial allo‐HSCT. Among these 85 patients, we stratified 33 patients into the MUD‐HSCT group and 52 to the haplo‐HSCT group. The primary outcomes were OS and LFS. The median OS was not reached in the haplo‐HSCT group, while it reached 29.8 months in patients undergoing MUD‐HSCT (p = .211). Likewise, the median LFS periods were 52.6 months in the haplo‐HSCT group and 12.7 months in the MUD‐HSCT group (p = .212). Importantly, neither the OS nor LFS showed substantial differences between the MUD‐HSCT and haplo‐HSCT groups. Furthermore, univariate analyses revealed that haplo‐HSCT did not demonstrate a significantly higher risk of worse LFS (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.38–1.25; p = .216) or OS (HR, 0.67; 95% CI, 0.36–1.26; p = .214) than MUD‐HSCT. Notably, a high European Group for Blood and Marrow Transplantation risk score (HR, 1.44; 95% CI, 1.10–1.87; p = .007) and non‐complete remission (HR, 2.48; 95% CI, 1.17–5.23; p = .017) were significantly correlated with worse OS.ConclusionHaplo‐HSCT may serve as an alternative to MUD‐HSCT for the treatment of acute leukemia, offering similar survival outcomes.

Funder

Taichung Veterans General Hospital

National Science and Technology Council

Publisher

Wiley

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