Haploidentical Allogeneic Transplantation Provides Comparable Outcomes to HLA-Matched or Mismatched Unrelated Donor Grafts in Hematological Malignancies

• Published in: Blood 2014-12, Vol.124 (21), p.1226-1226
• Main Authors: Baker, Melissa F, Kim, Daniel, Donato, Michele L, Pecora, Andrew L, Vesole, David H., Skarbnik, Alan P, Adler-Brecher, Barbara, Boonstra, Michele, Diaz, Brenda, McKiernan, Phyllis, Sutherland, Pamela, Rowley, Scott D
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V124.21.1226.1226

Haploidentical (HAPLO) and unrelated donors (URD) are established cell sources for patients (pts) who lack HLA-matched siblings. Limited data are available comparing transplant (TP) outcomes using cells from HAPLO vs URD donors. We performed a retrospective analysis of sequential pts (n=54) undergoing HAPLO transplants with post-transplant cyclophosphamide (Cy). A control group of HLA 7/8 or 8/8 matched URD recipients (n=59) matched by diagnosis, transplant date, and cell source (PBSC or marrow) was identified (Table). Most HAPLO pts received cycles of pre-TP fludarabine (Flu) for lymphodepletion to achieve CD4 0.5x109/l at a median of 16 days (range: 13-45) vs 13 days (range: 9-25, p20x109/l median 24 days (range: 13-109) vs 15 days (range: 8-216, p= 0.02). ANC and PLT recoveries were faster for URD PB compared to BM recipients. However, engraftment kinetics did not differ for HAPLO PB or BM recipients, (ANC median days 16.5 vs. 16, p=0.38; PLT median 24 vs 26 days p=0.80). HAPLO donor CD3 engraftment was robust, with 44 of 48 (92%) HAPLO compared to 37 of 52 (71%) URD recipients achieving >95% CD3+ chimerism at day +28 (p=0.01). Engraf