EBMT 2018 | Allo-HSCT from unrelated cord blood or haploidentical donor grafts in sAML patients

Annalisa Ruggeri from Hôpital Saint-Antoine, Paris, FR, presented at the 44^th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), Lisbon, Portugal on behalf of colleagues data from a retrospective study which evaluated the outcomes of secondary acute myeloid leukemia (sAML) patients who underwent allogeneic hematopoietic cell transplantation (allo-HSCT) from either an unrelated umbilical cord blood (UCBT) or haploidentical (Haplo) donor.   

In this study, the outcomes of 409 adult sAML patients who received either UCBT (n = 163, median age at transplant = 56 years) or Haplo (n = 246, median age at transplant = 59.7 years) transplantation at EBMT centers between 2007–2016 were retrospectively compared. The median follow-up time for the UCBT or Haplo groups were 24.3 (3.0–112.3) months and 16.9 (2.5–101.0) months respectively.

Key findings:

• Cumulative incidence of grade II–IV acute graft versus host disease (GvHD) at 100 days in the UCBT and Haplo group: 33% vs 23%, P = 0.018
• 2-year cumulative incidence of chronic GvHD in the UCBT and Haplo group: 26% vs 26%, P = 0.706
• 2-year relapse incidence in the UCBT and Haplo group: 33% vs 30%, P = 0.380
• 2-year non relapse mortality (NRM) rate in the UCBT and Haplo group: 34% vs 41%, P = 0.711
• 2-year survival in the UCBT and Haplo groups respectively
  • Leukemia-free survival (LFS): 26% vs 36%, P = 0.235
  • Overall survival (OS): 29% vs 41%, P = 0.246
• Compared to Haplo, UCBT associated significantly with higher risk of grade II-IV acute GVHD (HR = 1.9, P = 0.009) and lower GHVD-free-relapse-free-survival (HR = 1.57, P = 0.007)

In summary, Haplo transplantation associated with a lower acute GvHD and higher GRFS. However, there were no significant differences in OS, LFS, relapse, NRM and chronic GvHD between the Haplo and UCBT groups.

The speaker concluded by stating that the findings of this retrospective study demonstrate that both Haplo and UCBT transplant strategies are “valid options for patients” with sAML.