期刊
LEUKEMIA
卷 30, 期 2, 页码 447-455出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/leu.2015.232
关键词
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资金
- EBMT
- Swedish Cancer Society [CAN2013/671]
- Swedish Research Council [K2014-64X-05971-34-4]
- Children's Cancer Foundation [PR2013-0045]
- Cancer Society in Stockholm [111293]
- Karolinska Institutet
Haploidentical hematopoietic stem cell transplants (HSCTs) are increasingly used, but it is unknown whether they have a stronger graft-versus-leukemia (GVL) effect. We analyzed 10 679 acute leukemia patients who underwent HSCT from an HLA-matched sibling donor (MSD, n=9815) or a haploidentical donor (>= 2 HLA-antigen disparity, n=864) between 2007 and 2012, reported to the European Group for Blood and Marrow Transplantation. In a Cox regression model, acute and chronic graft-versus-host disease (GVHD) was added as time-dependent variables. There was no difference in probability of relapse between recipients of haploidentical and MSD grafts. Factors of importance for relapse after T-cell-replete grafts included remission status at HSCT, Karnofsky score 80, acute GVHD of grade II or higher and chronic GVHD (P < 10(-5)). Patients with post-transplant cyclophosphamide (n =194) had similar outcome as other T-cell-replete haploidentical transplants (n=369). Non-relapse mortality was significantly higher in the haploidentical group compared with that in MSD patients (P < 10(-5)). Leukemia-free survival was superior in the MSD patients receiving T-cell-replete (P < 10-5) or T-cell-depleted grafts (P = 0.0006). The risk of relapse was the same in acute leukemia patients who received haploidentical donor grafts as in those given MSD transplants, suggesting a similar GVL effect.
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