The use of unmanipulated graft is increasingly adopted in the setting of allogeneic hematopoietic stem cell transplantation from haploidentical family donors (haplo-SCT) in acute leukemia (AL). We analyzed the outcome of 229 adult patients with de novo AL, who received an unmanipulated haploidentical transplant as their first allo-SCT between 2007 and 2011. Median follow-up was 30 months. Disease status at transplant was: first complete remission (CR1) for 77, second CR (CR2) for 56, and advanced for 96 patients. One hundred and seventy-one patients received in vivo T-cell depletion by monoclonal antibodies (75%). The 60-day cumulative incidence (CI) of engraftment was 93±2%. The 100-day CI of acute graft-versus-host disease (GvHD) was 32±3% for grade II–IV, 12±3% for grade III–IV. The 3-year CI of chronic GvHD was 34±3%. The 3-year CI of non-relapse mortality was 31±4% with in vivo T-cell depletion and 17±5% without. At 3 years, for patients transplanted in CR1, CR2 or advanced disease leukemia-free survival was 44±6, 42±7 and 12±3%, overall survival was 55±6, 51±7 and 14±4% and CI of relapse was 32±6, 24±6 and 61±5%, respectively. These data suggest that unmanipulated haplo-SCT is a valid treatment option for adult AL patients in complete remission lacking a matched donor.
Access optionsAccess options
Subscribe to Journal
Get full journal access for 1 year
only $102.00 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
We thank all the allogeneic transplantation centers of the EBMT group for reporting the data included in this analysis to this registry. A list of the participating EBMT centers appears in the Appendix.
SP designed research, collected and checked the data, contacted transplantation centers, analyzed data and wrote the paper; ML designed research, analyzed data and wrote the paper; FC designed research and wrote the paper; AB and JT provided data and wrote the paper; N-CG wrote the paper; HH SS, YK, WD, BD, EG and WA provided data; AN and MM wrote the paper.
EBMT participating centers: Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan (61 patients); Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy (30 patients); Division of Hematology II, IRCCS, San Martino University Hospital—IST, Genoa, Italy (21 patients); The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (17 patients); Department of Hematology, Ospedale Civile, Pescara, Italy (16 patients); Hematopoietic Stem Cell Transplantation Unit, MedicalPark Hospital, Antalya, Turkey (13 patients); First Affiliated Hospital of Soochow University, Suzhou, China (13 patients); Department of Bone Marrow Transplantation, University Hospital, Essen, Germany (8 patients); University Hospital of Munich-Klinikum Grosshadern (LMU), Department of Internal Medicine III, Hematopoietic Cell Transplantation, Munich, Germany (6 patients); Medizinische Klinik und Poliklinik I, Universitaetsklinikum Carl Gustav Carus der TU Dresden, Dresden, Germany (6 patients); Azienda Ospedaliera, Reggio Calabria, Italy (5 patients); University Hospital Gasthuisberg, Leuven, Belgium (4 patients); Azienda Ospedali Riuniti di Ancona, Ancona-Torrete, Italy (4 patients); University Hospital, Basel, Switzerland (3 patients); University Hospital, Udine, Italy (3 patients); Gazi Universitesi Tip Fakültesi, Ankara, Turkey (2 patients); University Med. Center, Ljubljana, Slovenia (2 patients); Heilig Hartziekenhuis, Roeselare, Belgium (2 patients); Tel-Aviv University, Tel-Hashomer, Israel (2 patients); Hospital Guglielmo da Saliceto, Piacenza, Italy (1 patient); Universität Tübingen, Tübingen, Germany (1 patient); Unité de transplantation et de thérapie cellulaire, Marseille, France (1 patient); Ospedale S. Camillo-Forlanini, Rome, Italy (1 patient); Centre For Clinical Haematology, Birmingham, United Kingdom (1 patient); King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (1 patient); Helsinki University Central Hospital, Helsinki, Finland (1 patient); University Hospital Eppendorf, Hamburg, Germany (1 patient); Shariati Hospital,Teheran, Iran (1 patient); Umea University Hospital, Umeå, Sweden (1 patient); and University of Freiburg, Freiburg, Germany (1 patient).
About this article
Eltrombopag is an effective and safe therapy for refractory thrombocytopenia after haploidentical hematopoietic stem cell transplantation
Bone Marrow Transplantation (2019)