Skip to main content
eScholarship
Open Access Publications from the University of California

UCSF

UC San Francisco Previously Published Works bannerUCSF

Haploidentical vs sibling, unrelated, or cord blood hematopoietic cell transplantation for acute lymphoblastic leukemia.

  • Author(s): Wieduwilt, Matthew J;
  • Metheny, Leland;
  • Zhang, Mei-Jie;
  • Wang, Hai-Lin;
  • Estrada-Merly, Noel;
  • Marks, David I;
  • Al-Homsi, A Samer;
  • Muffly, Lori;
  • Chao, Nelson;
  • Rizzieri, David;
  • Gale, Robert Peter;
  • Gadalla, Shahinaz M;
  • Cairo, Mitchell;
  • Mussetti, Alberto;
  • Gore, Steven;
  • Bhatt, Vijaya Raj;
  • Patel, Sagar S;
  • Michelis, Fotios V;
  • Inamoto, Yoshihiro;
  • Badawy, Sherif M;
  • Copelan, Edward;
  • Palmisiano, Neil;
  • Kharfan-Dabaja, Mohamed A;
  • Lazarus, Hillard M;
  • Ganguly, Siddhartha;
  • Bredeson, Christopher;
  • Diaz Perez, Miguel Angel;
  • Cassaday, Ryan;
  • Savani, Bipin N;
  • Ballen, Karen;
  • Martino, Rodrigo;
  • Wirk, Baldeep;
  • Bacher, Ulrike;
  • Aljurf, Mahmoud;
  • Bashey, Asad;
  • Murthy, Hemant S;
  • Yared, Jean A;
  • Aldoss, Ibrahim;
  • Farhadfar, Nosha;
  • Liu, Hongtao;
  • Abdel-Azim, Hisham;
  • Waller, Edmund K;
  • Solh, Melhem;
  • Seftel, Matthew D;
  • van der Poel, Marjolein;
  • Grunwald, Michael R;
  • Liesveld, Jane L;
  • Kamble, Rammurti T;
  • McGuirk, Joseph;
  • Munker, Reinhold;
  • Cahn, Jean-Yves;
  • Lee, Jong Wook;
  • Freytes, César O;
  • Krem, Maxwell M;
  • Winestone, Lena E;
  • Gergis, Usama;
  • Nathan, Sunita;
  • Olsson, Richard F;
  • Verdonck, Leo F;
  • Sharma, Akshay;
  • Ringdén, Olle;
  • Friend, Brian D;
  • Cerny, Jan;
  • Choe, Hannah;
  • Chhabra, Saurabh;
  • Nishihori, Taiga;
  • Seo, Sachiko;
  • George, Biju;
  • Baxter-Lowe, Lee Ann;
  • Hildebrandt, Gerhard C;
  • de Lima, Marcos;
  • Litzow, Mark;
  • Kebriaei, Partow;
  • Hourigan, Christopher S;
  • Abid, Muhammad Bilal;
  • Weisdorf, Daniel J;
  • Saber, Wael
  • et al.
Abstract

The role of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for acute lymphoblastic leukemia (ALL) is being defined. We performed a retrospective, multivariable analysis comparing outcomes of HCT approaches by donor for adults with ALL in remission. The primary objective was to compare overall survival (OS) among haploidentical HCTs using PTCy and HLA-matched sibling donor (MSD), 8/8 HLA-matched unrelated donor (MUD), 7 /8 HLA-MUD, or umbilical cord blood (UCB) HCT. Comparing haploidentical HCT to MSD HCT, we found that OS, leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and acute graft-versus-host disease (aGVHD) were not different but chronic GVHD (cGVHD) was higher in MSD HCT. Compared with MUD HCT, OS, LFS, and relapse were not different, but MUD HCT had increased NRM (hazard ratio [HR], 1.42; P = .02), grade 3 to 4 aGVHD (HR, 1.59; P = .005), and cGVHD. Compared with 7/8 UD HCT, LFS and relapse were not different, but 7/8 UD HCT had worse OS (HR, 1.38; P = .01) and increased NRM (HR, 2.13; P ≤ .001), grade 3 to 4 aGVHD (HR, 1.86; P = .003), and cGVHD (HR, 1.72; P ≤ .001). Compared with UCB HCT, late OS, late LFS, relapse, and cGVHD were not different but UCB HCT had worse early OS (≤18 months; HR, 1.93; P < .001), worse early LFS (HR, 1.40; P = .007) and increased incidences of NRM (HR, 2.08; P < .001) and grade 3 to 4 aGVHD (HR, 1.97; P < .001). Haploidentical HCT using PTCy showed no difference in survival but less GVHD compared with traditional MSD and MUD HCT and is the preferred alternative donor HCT option for adults with ALL in complete remission.

Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.

Main Content
For improved accessibility of PDF content, download the file to your device.
Current View