%0 Journal Article
%T Post-transplantation cyclophosphamide-based haploidentical versus Atg-based unrelated donor allogeneic stem cell transplantation for patients younger than 60 years with hematological malignancies: a single-center experience of 209 patients
%J -
%D 2018
%R https://doi.org/10.1038/s41409-018-0387-y
%X Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is limited by availability of HLA-matched sibling donors (MSDs). The alternative use of unrelated donors (UDs) is currently challenged by haploidentical-related donors (HRDs). We retrospectively analyzed 209 consecutive patients younger than 60 years undergoing allo-HSCT from UDs (n£¿=£¿128) or HRDs (n£¿=£¿81). Cumulative incidences of grade 3¨C4 acute (17 vs. 2%, p£¿=£¿0.003) and 2-year moderate and severe chronic (20 vs. 2%, p£¿<£¿0.001) GVHD were significantly higher with UD. Progression-free survival (PFS) was significantly better with HRD (51 vs. 69%, p£¿=£¿0.019), without significant difference in the cumulative incidence of relapse (CIR), non-relapse mortality (NRM), and overall survival (OS). Multivariate analyses confirmed the lower risk of acute and chronic GVHD (grade 2¨C4, HR£¿=£¿0.43, p£¿=£¿0.005; grade 3¨C4, HR£¿=£¿0.20, p£¿=£¿0.017; all grades, HR£¿=£¿0.43, p£¿=£¿0.012; moderate or severe, HR£¿=£¿0.12, p£¿=£¿0.004), better PFS (HR£¿=£¿0.61, p£¿=£¿0.046), and GRFS (HR£¿=£¿0.47, p£¿=£¿0.001) with HRD. This was confirmed in match-paired analysis. In the absence of MSDs, HRD could be considered as a suitable alternative for patients younger than 60 years
%U https://www.nature.com/articles/s41409-018-0387-y