Haploidentical versus HLA-matched sibling transplantation for refractory acute leukemia undergoing sequential intensified conditioning followed by DLI: an analysis from two prospective data

Journal of Hematology & Oncology

Ting Yang¹  Shunqing Wang²  Zujun Jiang³  Qifa Liu⁴  Xiaojun Huang⁴  Sijian Yu⁴  Zhiping Fan⁴  Jieyu Ye⁴  Jing Sun⁴  Fen Huang⁴  Ren Lin⁴  Na Xu⁴  Li Xuan⁴  Yu Wang⁵  Danian Nie⁶  Yajing Xu⁷  Dongjun Lin⁸ 

[1] Department of Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital;Department of Hematology, Guangzhou First People’s Hospital;Department of Hematology, Guangzhou General Hospital of Guangzhou Military Command;Department of Hematology, Nanfang Hospital, Southern Medical University;Department of Hematology, Peking University People’s Hospital, Peking University Institute of Hematology;Department of Hematology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University;Department of Hematology, Xiangya Hospital, Central South University;Department of Hematology, the Third Affiliated Hospital, Sun Yat-Sen University;

关键词: HLA-matched sibling;    Haploidentical;    Refractory acute leukemia;    Similar survival;    Transplantation;   

DOI  :  10.1186/s13045-020-00859-5

来源: DOAJ

【 摘 要 】

Abstract Background Compared with HLA-matched sibling donor (MSD) transplant, the outcomes of haploidentical donor (HID) transplant for refractory acute leukemia need to be further explored. In this study, we compared the outcomes of HID with MSD for refractory acute leukemia. Patients and methods This study population came from two prospective multicenter trials (NCT01883180, NCT02673008). Two hundred and seventy-eight patients with refractory acute leukemia were enrolled in this study, including 119 in HID group and 132 in MSD group. Sequential intensified conditioning was employed in all patients, and donor lymphocyte infusion (DLI) was administered in patients in the absence of active GVHD and according to minimal residual disease (MRD) from day + 60 post-transplantation for preventing relapse. Results The complete remission of leukemia by day + 30 post-transplant were 94% and 93%, respectively, in HID and MSD groups (p = .802). The 1-year incidence of grades II–IV acute GVHD was 62% and 54% (p = .025), and 3-year incidence of chronic GVHD was 55% and 55% (p = .789), respectively, in two groups. HID transplant had lower incidence of first episode of MRD positivity and relapse than MSD transplant (28% vs 45%, p = .006; 26% vs 38%, p = .034). There was higher infection-related mortality in HID than MSD (8% vs 2%, p = .049) within the first 100 days’ post-transplant. The 5-year overall survival was 46% and 42% (p = .832), respectively; the 5-year disease-free survival was 43% and 39% (p = .665), in HID and MSD groups, respectively. Conclusions HID transplant has lower relapse, but higher infection-related mortality and similar survival rates in refractory acute leukemia by the strategy of sequential intensified conditioning followed by DLI compared with MSD transplant.

【 授权许可】

Unknown