T-cell replete peripheral blood haploidentical hematopoietic cell transplantation with post-transplant cyclophosphamide results in outcomes similar to traditionally matched donors in active disease acute myeloid leukemia

Outcomes for acute myeloid leukemia (AML) patients who fail to achieve complete remission remain poor. Hematopoietic cell transplantation (HCT) has been shown to induce long-term survival in AML patients with active disease. HCT is largely performed with HLA- matched unrelated or HLA-matched related donors. Recently, HCT with HLA-haploidentical related donors has been identified as a feasible option when HLA-matched donors are not immediately available. However, there is little data comparing outcomes of AML patients with active disease who receive haploidentical versus traditionally matched HCT. We retrospectively analyzed data from 99 AML patients with active disease undergoing allogeneic HCT at a single institution. Forty-three patients received unrelated donor HCT, 32 patients received matched related donor HCT, and 24 patients received peripheral blood haploidentical HCT with post- transplant cyclophosphamide. We found no significant differences between treatment groups in terms of overall survival (OS), event-free survival (EFS), transplant-related mortality (TRM), cumulative incidence of relapse, and cumulative incidence of acute and chronic graft versus host disease (GvHD). We performed univariate regression analysis of variables that modified OS in all patients, and found only younger age at transplant and development of chronic GvHD significantly improved outcome. Although limited by our relatively small sample size, these results indicate that haploidentical HCT in active AML patients have comparable outcomes to HCT with traditionally matched donors. Haploidentical HCT can be considered in this the use of haploidentical HCT compared to matched unrelated or related HCT. 17 Comparative outcomes in active disease however remain unknown. We retrospectively analyzed outcomes from active disease AML patients who underwent unrelated donor, related donor or haploidentical HCT. While haploidentical HCT has been shown to be feasible in active AML patients, there is little data on how outcomes of haploidentical HCT compare to those of traditionally matched donor HCT. 18 last