A survey of fully haploidentical hematopoietic stem cell transplantation in adults with high-risk acute leukemia: a risk factor analysis of outcomes for patients in remission at transplantation.

Abstract

Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is an alternative treatment to patients with high-risk acute leukemia lacking a human leukocyte antigen-matched donor. We analyzed 173 adults with acute myeloid leukemia (AML) and 93 with acute lymphoblastic leukemia (ALL) who received a haplo-HSCT in Europe. All grafts were T cell-depleted peripheral blood progenitor cells from a direct family or other related donor. At transplantation, there were 25 patients with AML in CR1 (complete remission 1), 61 in more than or equal to CR2, and 87 in nonremission, and 24 with ALL in CR1, 37 in more than or equal to CR2, and 32 in nonremission. Median follow-up was 47 months in AML and 29 months in the ALL groups. Engraftment was observed in 91% of the patients. Leukemia-free survival at 2 years was 48% plus or minus 10%, 21% plus or minus 5%, and 1% for patients with AML undergoing transplantation in CR1, more than or equal to CR2, and nonremission, and 13% plus or minus 7%, 30% plus or minus 8%, and 7% plus or minus 5% in ALL patients, respectively. In conclusion, haplo-HSCT can be an alternative option for the treatment of high-risk acute leukemia patients in remission, lacking a human leukocyte antigen-matched donor.

• Authors: Fabio Ciceri, Myriam Labopin, Franco Aversa, Jakob M Rowe, Donald Bunjes, Philippe Lewalle, Arnon Nagler, Paolo Di Bartolomeo, João F Lacerda, Maria Teresa Lupo Stanghellini, Emmanuelle Polge, Francesco Frassoni, Massimo F Martelli, Vanderson Rocha, Acute Leukemia Working Party (ALWP) of European Blood and Marrow Transplant (EBMT) Group
• Journal: Blood (Blood) Vol. 112 Issue 9 Pg. 3574-81 (Nov 01 2008) ISSN: 1528-0020 [Electronic] United States
• PMID: 18606875 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Morpholines
• RE 102

Topics

• Adolescent
• Adult
• Aged
• Disease-Free Survival
• Europe (epidemiology)
• Female
• Graft Survival
• Graft vs Host Disease (etiology)
• Haplotypes (immunology)
• Hematopoietic Stem Cell Transplantation (adverse effects, mortality)
• Humans
• Leukemia, Myeloid, Acute (immunology, therapy)
• Lymphocyte Transfusion
• Male
• Middle Aged
• Morpholines
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (immunology, therapy)
• Registries
• Risk Factors
• Tissue Donors
• Treatment Outcome