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Haploidentical transplant in adult patients with acute lymphoblastic leukemia in Argentina: a comparison with matched related and unrelated donors

Bone Marrow Transplantation volume 55, pages 400–408 (2020)Cite this article

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Abstract

We aimed at analyzing the outcome of allogeneic stem cell transplant (ASCT) in adult patients with acute lymphoblastic leukemia (ALL), comparing Haploidentical (Haplo) with HLA-matched (sibling and unrelated) donors. Between 2008 and 2017, we collected data from 236 patients (median age 31 years; range 16–64; 90% HCT-CI 0–1) who underwent unmanipulated ASCT in first complete remission and subsequent remissions in 15 Argentinian centers. Donors were HLA-matched (n = 175; 74%) and Haplo (n = 61; 26%). Two-year overall survival (OS) was 55% (95% CI 47–63) for the HLA-matched group and 49% (95% CI 34–62) for the Haplo group (p = 0.351). For OS, crude HR, adjusted HR for covariates (HR 1.24; 95% CI 0.77–1.99; p = 0.363) and HR including a propensity score in the model (HR 1.22; 95% CI 0.71–2.08; p = 0.414) showed no impact of donor category on the OS. No difference was found in terms of nonrelapse mortality, relapse, leukemia-free survival, and grade 3–4 acute graft-versus-host disease (GVHD); 2-year incidence of chronic GVHD was higher in HLA-matched vs Haplo group (p = 0.028). Patients with ALL who underwent ASCT were young subjects with low HCT-CI. In this setting, a Haplo donor represents an alternative widely available in the absence of an HLA-matched donor. Relapse remains a challenge for all donor categories.

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Authors and Affiliations

  1. Hospital Italiano de Buenos Aires, CABA, Buenos Aires, Argentina

    Ana Lisa Basquiera, Diego Giunta, Gonzalo Ferini & Jorge A. Arbelbide

  2. Hospital Universitario Austral, Pilar, Buenos Aires, Argentina

    Mariano Berro & Gustavo Kusminsky

  3. Hospital Italiano de La Plata, Plata, Buenos Aires, Argentina

    Sebastián Yantorno & Milagros Szelagowski

  4. Sanatorio Anchorena, CABA, Buenos Aires, Argentina

    Martín Castro

  5. Fundacion Favaloro, CABA, Buenos Aires, Argentina

    Alejandro Requejo, Nicolás Fernandez Escobar & Gregorio Jaimovich

  6. Sanatorio Sagrado Corazón, CABA, Buenos Aires, Argentina

    Miguel Sorrentino & María Leticia Rapán

  7. Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina

    Daniel Sutovsky & Javier Bordone

  8. Hospital Británico, CABA, Buenos Aires, Argentina

    Silvina Palmer

  9. Instituto Alexander Fleming, CABA, Buenos Aires, Argentina

    Adriana Vitriu

  10. Hospital Italiano de San Justo, San Justo, Buenos Aires, Argentina

    Georgina Bendek

  11. CEMIC, CABA, Buenos Aires, Argentina

    Patricio Duarte

  12. Centro de Hematología y Trasplante de Rosario, Rosario, Argentina

    Amalia Cerutti

  13. CETRAMOR, Rosario, Argentina

    Maximiliano Cattaneo

  14. FUNDALEU, CABA, Buenos Aires, Argentina

    Juliana Martinez-Rolón

  15. Hospital Alemán, CABA, Buenos Aires, Argentina

    Vera Milovic

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  1. Ana Lisa Basquiera
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Basquiera, A.L., Berro, M., Yantorno, S. et al. Haploidentical transplant in adult patients with acute lymphoblastic leukemia in Argentina: a comparison with matched related and unrelated donors. Bone Marrow Transplant 55, 400–408 (2020). https://doi.org/10.1038/s41409-019-0687-x

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