Hematopoietic stem cell transplantation in acute myeloid leukemia from haploidentical donors compared with HLA-matched related donors

Abstract

Haploidentical SCT is an appropriate alternative for patients with acute myeloid leukemia (AML) in absence of compatible familial donor. Results of 57 haplo-SCT and 21 matched related donor SCT of patients with AML were assessed in the present study. Our aim was to compare clinical efficiency, complication rates and outcomes in the patients transplanted from related haploidentical donors versus HLA-compatible related donors. The rate of graft failure proved to be higher in haplo-SCT (10.6% and 0%, р=0.31) and cumulative frequency of platelet recovery was much lesser in haplo-SCT group (65.2% and 100%, р=0.00013). However, the time before recovery of granulocytopoiesis and thrombocytopoiesis was similar. Frequencies of acute GVHD, RFS and OS were comparable. In MRD-HSCT group was tendency for higher rate of chronic GVHD (9.0% and 22.9%, p=0.07) and relapse (40.7% and 16.6%, p=0.15).Active disease was the only factor with negative influence on results of SCT. Haplo-SCT was associated with higher rate of D+30 (р=0.001) and 100-d (р=0.011) mortality. In the group of patients after haplo-SCT without early mortality, GVHD grade 3-4 had negative influence on results of SCT. Hence, haploidentical HSCT is a plausible alternative for AML patients if HLA-compatible donor is not available. In particular, best results are obtained when haplo-HSCT is performed in the 1 st complete clinical remission.