Outcomes with HLA-matched unrelated donor versus haploidentical hematopoietic cell transplantation

Abstract

We investigated the outcomes after adult haploidentical (haplo) and matched unrelated donor (MUD) hematopoietic cell transplantation (HCT) in a single-center study (n = 452) including 276 MUD and 176 haplo transplants. Myeloablative (37%) and reduced-intensity conditioning (63%) were performed. Graft sources included peripheral blood (50%) and bone marrow (50%). GVHD prophylaxis included tacrolimus/methotrexate (53%) and post-transplant cyclophosphamide-based (47%). In MUD versus haplo HCT recipients, a similar incidence of neutrophil engraftment (18 vs 17 days, p = 0.895), grade II-IV acute GVHD (51% vs 50%, p = 0.773), relapse (26% vs 23%, p = 0.578), non-relapse mortality (22% vs 23%, p = 0.817), 1-year disease-free survival (62% vs 63%. p = 0.921), and 1-year overall survival (73% vs 74%, p = 0.744) were observed. Earlier platelet engraftment (22 vs 27 days, p < 0.001) and higher chronic GVHD (45% vs 35%, p = 0.040) were noted in MUD as compared to haplo HCT. Allogeneic transplantation should be done promptly whenever indicated, utilizing either matched unrelated or haploidentical donors.

Keywords:

• Matched unrelated donor
• haploidentical donor
• allogeneic hematopoietic stem cell transplantation
• outcomes

Acknowledgements

The authors are indebted to the patients and the staff at the University of Kansas Medical Center Blood and Marrow Transplant program.

Ethical approval and consent to participate

The study was approved by the Institutional Review Board of the University of Kansas Medical Center, Kansas City, KS (USA).

Consent for publication

A signed informed consent was obtained.

Authors’ contributions

All authors contributed to the manuscript and fulfilled criteria per the uniform requirements set forth by the International Committee of Medical Journal Editors (ICJME) guidelines. All authors have reviewed and approved the final version of the manuscript.

Disclosure statement

No relevant conflict of interest. SHA has speaking, consulting and advisory roles, and research funding from Incyte and Therakos. JPM has speaking, consulting and advisory role in Kite, Juno Therapeutics, Allovir, Magenta Therapeutics, EcoR1 Capital, and has research funding from Novartis, Fresenius Biotech, Astellas Pharma, Bellicum Pharmaceuticals, Gamida Cell, Pluristem Therapeutics, Kite and AlloVir. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Disclosure of prior presentation/publication

This manuscript has not been previously published and has not been submitted for publication elsewhere while under consideration.

Data availability statement

The dataset used in this study is submitted to the centralized registry dataset maintained by the Center for International Blood and Marrow Transplant Research (CIBMTR). Further inquiries can be directed to the corresponding author.

Additional information

Funding

This paper did not receive any financial support.