Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, No 11 Xizhimen South Street, Beijing, 100044, China.
Peking-Tsinghua Center for Life Sciences, Beijing, China.
Ann Hematol. 2021 Feb;100(2):555-562. doi: 10.1007/s00277-020-04359-x. Epub 2021 Jan 7.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative treatment for acute myeloid leukemia (AML). We explored the outcome of haploidentical donor (HID) transplantation for intermediate-risk AML and compared to that of matched sibling donor (MSD) transplants. One hundred twenty-seven consecutive patients with intermediate-risk AML in the first complete remission (CR1) who underwent allo-HSCT between January 1, 2015, and August 1, 2016, were enrolled. Thirty-seven patients received MSD grafts, and 90 received HID grafts. The 2-year leukemia-free survival (LFS) of the HID group was comparable to that of the MSD group: 82.0% ± 4.1% versus 82.7% ± 6.4%, P = 0.457. The 2-year cumulative incidences of relapse and transplantation-related mortality (TRM) were comparable between the HID and MSD groups (relapse, 4.5% ± 0.1%, versus 11.5% ± 0.3%, P = 0.550; TRM, 13.4% ± 0.1% vs. 5.8% ± 0.2%, P = 0.154). The HID recipients had a trend of a lower 2-year cumulative incidence of positive posttransplant flow cytometry (FCM+) and relapse than the MSD recipients (5.6% ± 0.1% vs. 19.9% ± 0.5%, P = 0.092). These results suggest that the outcomes of allo-HSCT with HIDs are comparable to those with MSDs in terms of LFS, TRM, and relapse for intermediate-risk AML in CR1. HIDs could be an alternative to MSDs for intermediate-risk AML.
异基因造血干细胞移植（allo-HSCT）是治疗急性髓系白血病（AML）的有效方法。本研究探索了单倍体相合供者（HID）移植治疗中危 AML 的疗效，并与匹配同胞供者（MSD）移植进行比较。2015 年 1 月 1 日至 2016 年 8 月 1 日期间，127 例初诊为中危 AML 且处于完全缓解 1 期（CR1）的患者接受 allo-HSCT。其中 37 例患者接受 MSD 移植，90 例患者接受 HID 移植。HID 组与 MSD 组 2 年无白血病生存（LFS）率相当：82.0%±4.1%比 82.7%±6.4%，P=0.457。HID 组与 MSD 组 2 年复发率和移植相关死亡率（TRM）无显著差异（复发率：4.5%±0.1%比 11.5%±0.3%，P=0.550；TRM：13.4%±0.1%比 5.8%±0.2%，P=0.154）。HID 组患者 2 年阳性流式细胞术（FCM+）和复发的累积发生率呈下降趋势，而 MSD 组患者呈上升趋势（FCM+：5.6%±0.1%比 19.9%±0.5%，P=0.092；复发：5.6%±0.1%比 19.9%±0.5%，P=0.092）。这些结果表明，在 CR1 期的中危 AML 患者中，HID 移植与 MSD 移植相比，在 LFS、TRM 和复发方面具有相似的疗效。HID 可作为中危 AML 患者的替代供者。
