Comparing outcomes of a second allogeneic hematopoietic cell transplant using HLA-matched unrelated versus T-cell replete haploidentical donors in relapsed acute lymphoblastic leukemia: a study of the Acute Leukemia Working Party of EBMT

• Published in: Bone marrow transplantation (Basingstoke) 2021-09, Vol.56 (9), p.2194-2202
• Main Authors: Kharfan-Dabaja, Mohamed A., Labopin, Myriam, Bazarbachi, Ali, Ciceri, Fabio, Finke, Jürgen, Bruno, Benedetto, Bornhäuser, Martin, Gedde-Dahl, Tobias, Labussière-Wallet, Hélène, Niittyvuopio, Riitta, Valerius, Thomas, Angelucci, Emanuele, Brecht, Arne, Caballero, Dolores, Kuball, Jürgen, Potter, Victoria, Schmid, Christoph, Tischer, Johanna, Zuckerman, Tsila, Benedetti, Fabio, Blaise, Didier, Diez-Martin, Jose Luis, Sanz, Jaime, Ruggeri, Annalisa, Brissot, Eolia, Savani, Bipin N., Giebel, Sebastian, Nagler, Arnon, Mohty, Mohamad
• Format: Article
• Language: English
• Subjects: 631/67; 692/308/2171; Acute lymphoblastic leukemia; Acute lymphocytic leukemia; Adaptive immunology; Adult; Bone marrow; Bone marrow transplantation; Cancer; Care and treatment; Cell Biology; Graft vs Host Disease; Graft-versus-host reaction; Health aspects; Hematology; Hematopoietic Stem Cell Transplantation; Hematopoietic stem cells; Histocompatibility; Histocompatibility antigen HLA; Histocompatibility antigens; HLA histocompatibility antigens; Humans; Immunology; Internal Medicine; Leukemia; Leukemia, Myeloid, Acute; Life Sciences; Lymphatic leukemia; Lymphocytes B; Lymphocytes T; Male; Males; Medicine; Medicine & Public Health; Mud; Patient outcomes; Peripheral blood; Phenotypes; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Public Health; Relapse; Remission; Retrospective Studies; Statistical analysis; Stem cell transplantation; Stem Cells; Survival; T cells; T-Lymphocytes; Transplantation; Unrelated Donors
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/s41409-021-01317-7

Optimal donor choice for a second allogeneic hematopoietic cell transplant (allo-HCT) in relapsed acute lymphoblastic leukemia (ALL) remains undefined. We compared outcomes using HLA-matched unrelated donors (MUD) versus haploidentical donors in this population. Primary endpoint was overall survival (OS). The MUD allo-HCT group comprised 104 patients (male = 56, 54%), median age 36 years, mostly (76%) with B-cell phenotype in complete remission (CR) (CR2/CR3 + = 76, 73%). The 61 patients (male = 38, 62%) in the haploidentical group were younger, median age 30 years ( p  = 0.002), had mostly (79%) a B-cell phenotype and the majority were also in CR at time of the second allo-HCT (CR2/CR3 + = 40, 66%). Peripheral blood stem cells was the most common cell source in both, but a significantly higher number in the haploidentical group received bone marrow cells (26% vs. 4%, p