Superior <scp>GVHD</scp> ‐Free, Relapse‐Free Survival for Haploidentical Transplant With <scp>PTCy</scp> Than Matched Unrelated Donor for <scp>AML</scp> Patients Transplanted in Second Complete Remission: A Study From the Acute Leukemia Working Party

Donor preference for acute myeloid leukemia (AML) patients transplanted in second complete remission (CR2) remains unclear, and hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PTCy) from a haploidentical donor (HAPLO) merits attention. Data of 3878 adult AML patients receiving a first allo-HCT in CR2 from the European Society of Blood and Marrow Transplantation registry between 2010 and 2022 were analyzed. Univariate analyses and Cox regression models were used. Results of HCTs from 803 HAPLO PTCy, 1271 matched sibling donor (MSD), and 1804 matched unrelated donor (MUD) were analyzed. A higher proportion (80.7%) of patients with European LeukemiaNet (ELN2022) intermediate-/adverse-risk cytogenetics received an allo-HCT from HAPLO PTCy than from either MUD (79.6%) or MSD (70.2%). On multivariate analysis, HAPLO PTCy grafts (hazard ratio [HR] = 0.65, 95% confidence interval [CI] 0.51-0.82; p < 0.001) were associated with a lower relapse incidence (RI) compared with MSD HCTs, although non-relapse mortality was higher (HR = 1.77, 95% CI 1.34-2.34; p < 0.001). No difference was observed with respect to leukemia-free survival and graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) for HAPLO PTCy compared to MSD grafts. Notably, HAPLO PTCy HCT was associated with significantly lower RI (HR = 0.64, 95% CI 0.48-0.82; p < 0.001), chronic GVHD (cGVHD) (HR = 0.64, 95% CI 0.51-0.81; p < 0.001) and extensive cGVHD (HR = 0.47, 95% CI 0.34-0.66; p < 0.001) incidences compared to MUD HCTs. Collectively, HAPLO PTCy HCT was associated with superior GRFS (HR = 0.81, 95% CI 0.68-0.95; p = 0.013) than MUD HCT. For AML patients in CR2, HAPLO PTCy HCT is associated with lower RI and cGVHD, leading to superior GRFS compared with MUD HCTs.

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Publication Details

Journal
American Journal of Hematology
Published
2025-07-12
DOI
https://doi.org/10.1002/ajh.70008
Primary Topic
Hematopoietic Stem Cell Transplantation
Type
article
Field-Weighted Citation Impact
0.00

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article

Superior GVHD ‐Free, Relapse‐Free Survival for Haploidentical Transplant With PTCy Than Matched Unrelated Donor for AML Patients Transplanted in Second Complete Remission: A Study From the Acute Leukemia Working Party

Myriam Labopin, Yishan Ye, Éolia Brissot, Gèrard Socié et al.
American Journal of Hematology
Hematopoietic Stem Cell Transplantation
article

Superior GVHD ‐Free, Relapse‐Free Survival for Haploidentical Transplant With PTCy Than Matched Unrelated Donor for AML Patients Transplanted in Second Complete Remission: A Study From the Acute Leukemia Working Party

Myriam Labopin, Yishan Ye, Éolia Brissot, Gèrard Socié, Jimin Shi, Anna Maria Raiola, Didier Blaise, Fabio Ciceri, Ali Bazarbachi, Anne Huynh, Étienne Daguindau, Ibrahim Yakoub‐Agha, Arnon Nagler, Igor Wolfgang Blau, Tobias Gedde‐Dahl, Jenny Byrne, Yi Luo, Hélène Labussière‐Wallet, Lin Li, He Huang, Mohamad Mohty
article en

Abstract

Donor preference for acute myeloid leukemia (AML) patients transplanted in second complete remission (CR2) remains unclear, and hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PTCy) from a haploidentical donor (HAPLO) merits attention. Data of 3878 adult AML patients receiving a first allo-HCT in CR2 from the European Society of Blood and Marrow Transplantation registry between 2010 and 2022 were analyzed. Univariate analyses and Cox regression models were used. Results of HCTs from 803 HAPLO PTCy, 1271 matched sibling donor (MSD), and 1804 matched unrelated donor (MUD) were analyzed. A higher proportion (80.7%) of patients with European LeukemiaNet (ELN2022) intermediate-/adverse-risk cytogenetics received an allo-HCT from HAPLO PTCy than from either MUD (79.6%) or MSD (70.2%). On multivariate analysis, HAPLO PTCy grafts (hazard ratio [HR] = 0.65, 95% confidence interval [CI] 0.51-0.82; p < 0.001) were associated with a lower relapse incidence (RI) compared with MSD HCTs, although non-relapse mortality was higher (HR = 1.77, 95% CI 1.34-2.34; p < 0.001). No difference was observed with respect to leukemia-free survival and graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) for HAPLO PTCy compared to MSD grafts. Notably, HAPLO PTCy HCT was associated with significantly lower RI (HR = 0.64, 95% CI 0.48-0.82; p < 0.001), chronic GVHD (cGVHD) (HR = 0.64, 95% CI 0.51-0.81; p < 0.001) and extensive cGVHD (HR = 0.47, 95% CI 0.34-0.66; p < 0.001) incidences compared to MUD HCTs. Collectively, HAPLO PTCy HCT was associated with superior GRFS (HR = 0.81, 95% CI 0.68-0.95; p = 0.013) than MUD HCT. For AML patients in CR2, HAPLO PTCy HCT is associated with lower RI and cGVHD, leading to superior GRFS compared with MUD HCTs.

American Journal of HematologyVol. 100(10)
Oslo University Hospital (NO), Nottingham University Hospitals NHS Trust (GB), Sheba Medical Center (IL), Nottingham City Hospital (GB), Centre Hospitalier Universitaire de Lille (FR), Centre Hospitalier Universitaire de Toulouse (FR), Sorbonne Université (FR), Assistance Publique – Hôpitaux de Paris (FR), Hôpital Saint-Antoine (FR), American University of Beirut Medical Center (LB), Hôpital Lyon Sud (FR), IRCCS Ospedale San Raffaele (IT), Centre de Recherche Saint-Antoine (FR), Centre de Recherche en Cancérologie de Marseille (FR), Hôpital Saint-Louis (FR), Ospedale Policlinico San Martino (IT), Institut Paoli-Calmettes (FR), First Affiliated Hospital Zhejiang University (CN), Zhejiang University (CN), Charité - Universitätsmedizin Berlin (DE)
National Natural Science Foundation of China, Zhejiang University
Good health and well-being
Openalex Percentile: Top 79%
Hematopoietic Stem Cell Transplantation
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