Allogeneic hematopoietic cell transplantation (HSCT) remains an important curative treatment modality for patients with high risk acute leukemia (AL) (1). A matched unrelated donor (MUD) or a haploidentical related donor (Haplo HSCT), are both valid options in the absence of a fully HLA-matched sibling donor (MSD) for HSCT in AL. In my presentation I will present and discuss focusing on the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) registry based studies in recent few years (2-6) comparing MUD and Haplo HSCT for both acute myelogenous leukemia (AML) (2-3) and subsequently acute lymphoblasic leukemia (ALL) (4-7) addressing various aspects including type of grafts,conditioning regimens, GVHD prophylaxis and others in patients in remission and well as in those with active disease (2-7). In large our studies have shown comparable outcome including leukemia-free (LFS), overall survival (OS) and graft versus host disease (GVHD) free (Rel) free survival (GRFS) after Haplo-HSCT mostly with post transplantation cyclophosphamide (PTCy) versus MUD allo-HCT. Haplo HSCT with PTCy was usually associated with low transplant related mortality (7) and reduce incidence of chronic GVHD especially with bone marrow (BM) grafts (2). Moreover, Haplo HSCT associated TRM versus MUD associated TRM, impressively reduced with time (7) and results in ALL improved with time (6). As for the relapse rates and the graft versus leukemia (GVL) effect although still controversial, some of the data indicate lower Rel which may speak for stronger GVL afrer Haplo HSCT.
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Nagler A, Labopin M, Dholaria B, Angelucci E, Afanasyev B, Cornelissen JJ, Sica S, Meijer E, Ciceri F, Van Gorkom G, Kröger N, Martin H, Pioltelli P, Risitano A, Canaani J, Savani BN, Sanz J, Mohty M. Comparison of Haploidentical Bone Marrow versus Matched Unrelated Donor Peripheral Blood Stem Cell Transplantation with Posttransplant Cyclophosphamide in Patients with Acute Leukemia. Clin Cancer Res. 2021; 27(3):843-851.
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Sanz J, Galimard JE, Labopin M, Afanasyev B, Angelucci E, Ciceri F, Blaise D, Cornelissen JJ, Meijer E, Diez-Martin JL, Koc Y, Rovira M, Castagna L, Savani B, Ruggeri A, Nagler A, Mohty M Post-transplant cyclophosphamide after matched sibling, unrelated and haploidentical donor transplants in patients with acute myeloid leukemia: a comparative study of the ALWP EBMT. Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). J Hematol Oncol. 2020; 13(1):46.
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Al Malki MM, Yang D, Labopin M, Afanasyev B, Angelucci E, Bashey A, Socié G, Karduss-Urueta A, Helbig G, Bornhauser M, Niittyvuopio R, Ganser A, Ciceri F, Brecht A, Koc Y, Bejanyan N, Ferraro F, Kebriaei P, Mokhtari S, Ghobadi A, Nakamura R, Forman SJ, Champlin R, Mohty M, Ciurea SO, Nagler A. Comparing transplant outcomes in ALL patients after haploidentical with PTCy or matched unrelated donor transplantation. Blood Adv. 2020; 4(9):2073-2083.
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shem-Tov N, Peczynski C, Labopin M, Itälä-Remes M, Blaise D, Labussière-Wallet H, Socié G, Kröger N, Mielke S, Afanasyev B, Chevallier P, Tischer J, Helbig G, Jindra P, Peric Z, Giebel S, Mohty M, Nagler A. Haploidentical vs. unrelated allogeneic stem cell transplantation for acute lymphoblastic leukemia in first complete remission: on behalf of the ALWP of the EBMT. Leukemia. 2020; 34(1):283-292.
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Nagler A, Labopin M, Koc Y, Angelucci E, Tischer J, Arat M, Pioltelli P, Bernasconi P, Chiusolo P, Diez-Martin JL, Sanz J, Ciceri F, Peric Z, Giebel S, Canaani J, Mohty M Outcome of T-cell-replete haploidentical stem cell transplantation improves with time in adults with acute lymphoblastic leukemia: A study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Cancer. 2021. doi: 10.1002/cncr.33522.
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Shouval R, Fein JA, Labopin M, Kröger N, Duarte RF, Bader P, Chabannon C, Kuball J, Basak GW, Dufour C, Galimard JE, Polge E, Lankester A, Montoto S, Snowden JA, Styczynski J, Yakoub-Agha I, Mohty M, Nagler A. Outcomes of allogeneic haematopoietic stem cell transplantation from HLA-matched and alternative donors: a European Society for Blood and Marrow Transplantation registry retrospective analysis. Lancet Haematol. 2019; 6(11):e573-e584.
