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Allogeneic hematopoietic stem cell transplantation for intermediate-risk acute myeloid leukemia in the first remission: outcomes using haploidentical donors are similar to those using matched siblings

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative treatment for acute myeloid leukemia (AML). We explored the outcome of haploidentical donor (HID) transplantation for intermediate-risk AML and compared to that of matched sibling donor (MSD) transplants. One hundred twenty-seven consecutive patients with intermediate-risk AML in the first complete remission (CR1) who underwent allo-HSCT between January 1, 2015, and August 1, 2016, were enrolled. Thirty-seven patients received MSD grafts, and 90 received HID grafts. The 2-year leukemia-free survival (LFS) of the HID group was comparable to that of the MSD group: 82.0% ± 4.1% versus 82.7% ± 6.4%, P = 0.457. The 2-year cumulative incidences of relapse and transplantation-related mortality (TRM) were comparable between the HID and MSD groups (relapse, 4.5% ± 0.1%, versus 11.5% ± 0.3%, P = 0.550; TRM, 13.4% ± 0.1% vs. 5.8% ± 0.2%, P = 0.154). The HID recipients had a trend of a lower 2-year cumulative incidence of positive posttransplant flow cytometry (FCM+) and relapse than the MSD recipients (5.6% ± 0.1% vs. 19.9% ± 0.5%, P = 0.092). These results suggest that the outcomes of allo-HSCT with HIDs are comparable to those with MSDs in terms of LFS, TRM, and relapse for intermediate-risk AML in CR1. HIDs could be an alternative to MSDs for intermediate-risk AML.

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Acknowledgments

We thank the principal investigators and the skilled teams at each of the participating sites. We thank all colleagues for participating in the research.

Funding

This work was supported by the National Natural Science Foundation of China (grant no. 81770189, 82070189), the National Key Research and Development Program of China (2019YFC0840606) from the Ministry of Science and Technology, the Science and Technology Project of Guangdong Province of China 2016B030230003, the project of health collaborative innovation of Guangzhou city (no. 201704020214).

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Correspondence to Yu Wang.

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Ma, YR., Xu, LP., Zhang, XH. et al. Allogeneic hematopoietic stem cell transplantation for intermediate-risk acute myeloid leukemia in the first remission: outcomes using haploidentical donors are similar to those using matched siblings. Ann Hematol 100, 555–562 (2021). https://doi.org/10.1007/s00277-020-04359-x

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Keywords

  • Haploidentical donor
  • Matched sibling donor
  • Intermediate-risk
  • Acute myeloid leukemia