TY - JOUR
T1 - Matched related versus unrelated versus haploidentical donors for allogeneic transplantation in AML patients achieving first complete remission after two induction courses
T2 - a study from the ALWP/EBMT
AU - Nagler, Arnon
AU - Labopin, Myriam
AU - Mielke, Stephan
AU - Passweg, Jakob
AU - Blaise, Didier
AU - Gedde-Dahl, Tobias
AU - Cornelissen, Jan J.
AU - Salmenniemi, Urpu
AU - Yakoub-Agha, Ibrahim
AU - Reményi, Péter
AU - Socié, Gerard
AU - van Gorkom, Gwendolyn
AU - Labussière-Wallet, Hélène
AU - Huang, Xiao Jun
AU - Rubio, Marie Thérèse
AU - Byrne, Jenny
AU - Craddock, Charles
AU - Griškevičius, Laimonas
AU - Ciceri, Fabio
AU - Mohty, Mohamad
N1 - Funding Information:
We thank all the EBMT centers and national registries for contributing patients to this study (Supplementary Appendix material). We also thank the data managers for their excellent work.
Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/7
Y1 - 2023/7
N2 - We compared transplants (HSCT) from matched related siblings (MSD) with those from matched 10/10 and mismatched 9/10 unrelated (UD) and T-replete haploidentical (Haplo) donors in acute myeloid leukemia (AML) in first complete remission (CR1) achieved after two inductions, a known poor prognostic factor. One thousand two hundred and ninety-five patients were included: MSD (n = 428), UD 10/10 (n = 554), UD 9/10 (n = 135), and Haplo (n = 178). Acute GVHD II–IV was higher in all groups compared to MSD. Extensive chronic (c) GVHD was significantly higher in UD 9/10 (HR = 2.52; 95% CI 1.55–4.11, p = 0.0002) and UD 10/10 (HR = 1.48; 95% CI 1.03–2.13, p = 0.036) and cGVHD all grades were higher in UD 9/10 vs MSD (HR = 1.77; 95% CI 1.26–2.49, p = 0.0009). Non-relapse mortality was higher in all groups compared to MSD. Relapse incidence, leukemia-free, and overall survival did not differ significantly between donor types. Finally, GVHD-free relapse-free survival was lower in HSCT from UD 9/10 (HR = 1.56, 95% CI 1.20–2.03, p = 0.0009) but not in those from UD 10/10 (HR = 1.13, p = 0.22) and Haplo donors (HR = 1.12, p = 0.43) compared to MSD. In conclusion, in AML patients undergoing HSCT in CR1 achieved after two induction courses 10/10 UD and Haplo but not 9/10 UD donors are comparable alternatives to MSD.
AB - We compared transplants (HSCT) from matched related siblings (MSD) with those from matched 10/10 and mismatched 9/10 unrelated (UD) and T-replete haploidentical (Haplo) donors in acute myeloid leukemia (AML) in first complete remission (CR1) achieved after two inductions, a known poor prognostic factor. One thousand two hundred and ninety-five patients were included: MSD (n = 428), UD 10/10 (n = 554), UD 9/10 (n = 135), and Haplo (n = 178). Acute GVHD II–IV was higher in all groups compared to MSD. Extensive chronic (c) GVHD was significantly higher in UD 9/10 (HR = 2.52; 95% CI 1.55–4.11, p = 0.0002) and UD 10/10 (HR = 1.48; 95% CI 1.03–2.13, p = 0.036) and cGVHD all grades were higher in UD 9/10 vs MSD (HR = 1.77; 95% CI 1.26–2.49, p = 0.0009). Non-relapse mortality was higher in all groups compared to MSD. Relapse incidence, leukemia-free, and overall survival did not differ significantly between donor types. Finally, GVHD-free relapse-free survival was lower in HSCT from UD 9/10 (HR = 1.56, 95% CI 1.20–2.03, p = 0.0009) but not in those from UD 10/10 (HR = 1.13, p = 0.22) and Haplo donors (HR = 1.12, p = 0.43) compared to MSD. In conclusion, in AML patients undergoing HSCT in CR1 achieved after two induction courses 10/10 UD and Haplo but not 9/10 UD donors are comparable alternatives to MSD.
UR - http://www.scopus.com/inward/record.url?scp=85152451736&partnerID=8YFLogxK
U2 - 10.1038/s41409-023-01980-y
DO - 10.1038/s41409-023-01980-y
M3 - Article
C2 - 37045942
AN - SCOPUS:85152451736
SN - 0268-3369
VL - 58
SP - 791
EP - 800
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 7
ER -