| dc.description.abstract | HLA-haploidentical hematopoietic cell transplantation (Haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) has improved donor availability. However, a matched sibling donor (MSD) is still considered the optimal donor. Using the Center for International Blood and Marrow Transplant Research database, we compared outcomes after Haplo-HCT vs MSD in patients with acute myeloid leukemia (AML) in first complete remission (CR1). Data from 1205 adult CR1 AML patients (2008-2015) were analyzed. A total of 336 patients underwent PT-Cy-based Haplo-HCT and 869 underwent MSD using calcineurin inhibitor-based graft-versus-host disease (GVHD) prophylaxis. The Haplo-HCT group included more reduced-intensity conditioning (65% vs 30%) and bone marrow grafts (62% vs 7%), consistent with current practice. In multivariable analysis, Haplo-HCT and MSD groups were not different with regard to overall survival (P = .15), leukemia-free survival (P = .50), nonrelapse mortality (P = .16), relapse (P = .90), or grade II-IV acute GVHD (P = .98). However, the Haplo-HCT group had a significantly lower rate of chronic GVHD (hazard ratio, 0.38; 95% confidence interval, 0.30-0.48; P < .001). Results of subgroup analyses by conditioning intensity and graft source suggested that the reduced incidence of chronic GVHD in Haplo-HCT is not limited to a specific graft source or conditioning intensity. Center effect and minimal residual disease-donor type interaction were not predictors of outcome. Our results indicate a lower rate of chronic GVHD after PT-Cy-based Haplo-HCT vs MSD using calcineurin inhibitor-based GVHD prophylaxis, but similar other outcomes, in patients with AML in CR1. Haplo-HCT is a viable alternative to MSD in these patients. | en_US |
| dc.description.sponsorship | The CIBMTR is supported primarily by the National Institutes of Health (public health service grant/cooperative agreement 5U24CA076518 from the National Cancer Institute, National Heart, Lung, and Blood Institute, and National Institute of Allergy and Infectious Diseases and grant/cooperative agreement 4U10HL069294 from the National Heart, Lung, and Blood Institute and National Cancer Institute), the Health Resources and Services Administration/Department of Health and Human Services (contract HHSH250201200016C), and the Office of Naval Research (grants N00014-17-1-2388 and N0014-17-1-2850). The CIBMTR is also supported by Actinium Pharmaceuticals, Amgen, Amneal Biosciences, Angiocrine Bioscience, an anonymous donation to the Medical College of Wisconsin, Astellas Pharma US, Atara Biotherapeutics, Be the Match Foundation, bluebird bio, Bristol Myers Squibb Oncology, Celgene Corporation, Cerus Corporation, Chimerix, the Fred Hutchinson Cancer Research Center, Gamida Cell, Gilead Sciences, HistoGenetics, Immucor, Incyte Corporation, Janssen Scientific Affairs, Jazz Pharmaceuticals, Juno Therapeutics, Karyo-pharm Therapeutics, Kite Pharma, Medac, MedImmune, The Medical College of Wisconsin, Mediware, Merck & Co., Mesoblast, Meso Scale Diagnostics, Millennium, Miltenyi Biotec, the National Marrow Donor Program, Neovii Biotech NA, Novartis Pharmaceuticals Corporation, Otsuka Pharmaceutical (Japan), Patient-Centered Outcomes Research Institute, Pfizer, Pharmacyclics, PIRCHE, Sanofi Genzyme, Seattle Genetics, Shire, Spectrum Pharmaceuticals, St. Baldrick's Foundation, Sunesis Pharmaceuticals, Swedish Orphan Biovitrum, Takeda Oncology, Telomere Diagnostics, and the University of Minnesota. | en_US |
