title: 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.affiliation: Hematology and BMT Unit, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.forename: Myriam
authors.initials: M
authors.lastname: Labopin
authors.forename: Franco
authors.initials: F
authors.lastname: Aversa
authors.forename: Jakob M
authors.initials: JM
authors.lastname: Rowe
authors.forename: Donald
authors.initials: D
authors.lastname: Bunjes
authors.forename: Philippe
authors.initials: P
authors.lastname: Lewalle
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Bartolomeo
authors.forename: João F
authors.initials: JF
authors.lastname: Lacerda
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Lupo Stanghellini
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Polge
authors.forename: Francesco
authors.initials: F
authors.lastname: Frassoni
authors.forename: Massimo F
authors.initials: MF
authors.lastname: Martelli
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005060:Europe / Q000453:epidemiology; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology; D006239:Haplotypes / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000276:immunology / Q000628:therapy*; D017710:Lymphocyte Transfusion; D008297:Male; D008875:Middle Aged; D009025:Morpholines; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000628:therapy*; D012042:Registries; D012307:Risk Factors; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D009025:Morpholines; C006043:RE 102