Comparison of Transplant Outcomes in Patients with Acute Lymphoblastic Leukemia after Haploidentical Transplant with Post-Transplant Cyclophosphamide or Matched Unrelated Donor Transplant

摘要: Transplant outcomes for patients with acute lymphoblastic leukemia (ALL) after haploidentical hematopoietic cell transplantation (haploHCT) post-transplant cyclophosphamide (PTCy) compared to an HLA matched unrelated donors (MUD) are unknown. We, therefore retrospectively of 487 ALL who underwent haploHCT PTCy, reported from the participating centers (TCT-RC and EBMT) 01/2005 06/2018, a cohort 974 (1:2 ratio) MUD-HCT were EBMT.  Patients sex, disease stage (CR1, CR2, other), risk (high or others), Philadelphia chromosome status (positive negative), conditioning regimen (MAC RIC). Other significant differences in patient/transplant characteristics adjusted for. Median age at HCT was 33 years (range: 18-73) haplo 36 18-76) MUD; (p=0.024). time diagnosis transplant significantly longer (at 6 months: 23% vs. 29%; p=0.024). More group received female-to-male (27% 13%; p With median follow up 2 3 MUD, respectively, there no statistical overall survival (OS), (p=0.82); GvHD- relapse- free (GRFS), (p=0.78); relapse rate, (p=0.88); non-relapse mortality (NRM), (p=0.86) between haplo- recipients adjusting all covariates. (Fig 1) GvHD rates severity not different undergoing those MUD HCT, possibly due use ATG 2/3 HCT. However, related GVHD lower (HR= 0.45, p=0.003). We next did subgroup analysis based on intensity, first remission, status, stem source.  OS, disease-free (DFS), rate NRM comparable Engraftment faster if RIC used (HR=0.75, p=0.05), grade 2-4 BM graft source (HR =0.57, p=0.04). Severe chronic done CR1 0.52, p=0.05) 0.45 p=0.07). In conclusion, this large retrospective analysis, donor PTCy is 8/8 transplantations subgroups regardless status.