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Haploidentical-versus identical-sibling transplant for high-risk pediatric AML:A multi-center study

Cancer Communications 2020年第2期40卷 93-104页

作者： Feng-Mei Zheng Xi Zhang Chun-Fu Li Yi-Fei Cheng Li Gao Yue-Lin He Yu Wang Xiao-Jun Huang National Clinical Research Center for Hematologic Disease Beijing Key Laboratory of Hematopoietic Stem Cell TransplantationPeking University People’s HospitalPeking University Institute of HematologyBeijing100044P.R.China Department of Hematology Xinqiao HospitalArmy Military Medical UniversityChongqing400037P.R.China Department of Pediatrics Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong510515P.R.China Peking-Tsinghua Center for Life Sciences Beijing100871P.R.China

Background:Human leukocyte antigen-identical sibling donor(ISD)-hematopoietic stem cell transplantation(SCT)is a potentially curative treatment for high-risk pediatric acute myeloid leukemia(AML).A haploidentical donor(HID)is readily available to almost all *** studies have demonstrated that patients with HID-SCT had similar outcomes compared to ISD-SCT for pediatric and adult ***,the role of HID-SCT in high-risk pediatric AML is ***:To compare the overall survival of high-risk AML children who underwent either HID-SCT or ISD-SCT,we analyzed 179 cases of high-risk AML patients under 18 years of age treated with either ISD-SCT(n=23)or HID-SCT(n=156).Granulocyte colony-stimulating factor plus anti-thymocyte globulin-based regimens were used for *** also analyzed the subgroup data of AML patients at first complete remission(CR1)before SCT with known cytogenetic ***:The numbers of adverse cytogenetic risk recipients were 8(34.8%)and 13(18.8%)in the ISD-SCT group and the HID-SCT group,and the number of patients with disease status beyond CR1 were 6(26.1%)and 14(20.3%)in the two *** cumulative rates of grades II-IV acute graft-versus-host disease(GVHD)were 13.0%in the ISD-SCT group and 34.8%in the HID-SCT group(P=0.062),with a three-year cumulative rates of chronic GVHD at 14.1%and 34.9%,respectively(P=0.091).The relapse rate in the ISD-SCT group was significantly higher than that in the HID-SCT group(39.1%vs.16.4%,P=0.027);with non-relapse mortality at 0.0%and 10.6%(P=0.113),*** three-year overall survival rates were 73.0%for the ISD-SCT group and 74.6%for the HID-SCT group(P=0.689).In subgroup analysis,the three-year relapse rate in the ISD-SCT group was higher than that in the HID-SCT group(50.0%vs.9.2%,P=0.001)and the three-year DFS in the ISD-SCT group(50.0%)was lower than that in the HID-SCT group(81.2%)(P=0.021).Conclusions:Unmanipulated HID-SCT achieved DFS and OS outcomes comparable to those of

关键词： Acute myeloid leukemia high-risk pediatric transplantation haploidentical identical sibling propensity score matching graft-versus-host disease overall survival disease-free survival

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