Haploidentical Transplantation Outcome Is Not Inferior to Standard Matched Related and Unrelated Donor Transplantation: An Intention-to-Treat Analysis of 241 Patients with Acute Myeloid Leukemia

1920 Background. Understanding of leukemia biology and advances in the transplant field have improved the safety as well as access of allogeneic hematopoietic cell transplantation (HCT) for a larger number of patients (pts) affected by acute myeloid leukemia (AML). The trend of growth of HCTs in adult pts with AML can be expected to continue based on acceptance and availability of alternative donor. Few data are available for: i) the reliable estimates of the number of HCT for AML and the total number of AML pts for whom HCT is appropriate, ii) the choice of the different donor sources. A risk-adapted treatment strategy is crucial to improve the outcome of pts with AML. Our policy is to offer a haploidentical HCT to adult pts lacking a matched donor in the appropriate time according to clinical indications ([www.leukemianet.org][1], [www.ebmt.org][2]). This policy is integrated in ongoing protocols for primary disease ([www.nilg.it][3]). Methods. Here we are reporting the intention-to-treat (ITT) analysis of HCT in all consecutive AML pts referred to our Institution between January 2004 and April 2012. Classification, prognostic evaluation, response criteria and survival outcomes for AML were defined according to the standard recommendation of the European LeukemiaNet (Dohner H et al, Blood. 2010: 115:453–474). Results. Indication to HCT was given to 241 pts (median age 52y, r17-72, 66 pts over-60y; male 138). HCT was performed in 201/241 pts (median time from diagnosis to HCT 222 days, median time from HCT-indication to HCT 80 days), 24/201 pts received a second HCT due to disease relapse. Pts distribution according to ITT algorithm is reported in [figure 1][4]. In ITT analysis, 83,4% of candidate pts received an HCT. Characteristic related to pts/disease/transplant are reported in [table 1][5]. Noteworthy, pts in 1st complete remission (CR1) are evenly distributed according to donor source (namely HLA-matched sibling donor – MSD, unrelated donor – URD, haploidentical related donor - haplo-HCT). The overall survival (OS) analysis for pts transplanted in CR is 71% at 1y and 56% at 3y, for pts in morphologic leukemia free state (MLFS) 32% and 21%, for pts in relapse 23% and 11% (p/2 | 4 (9%) | 12 (29%) | 2 (28%) | 24 (18%) | | - MLFS | 1 (2%) | 3 (7%) | 2 (28%) | 7 (5%) | | - relapse | 14 (31%) | 3 (7%) | 3 (43%) | 74 (57%) | Table 1. Patients, disease and transplant characteristics. ![Figure][7] ![Figure][7] Disclosures: Bordignon: MolMed SpA: Employment. [1]: http://www.leukemianet.org [2]: http://www.ebmt.org [3]: http://www.nilg.it [4]: #F1 [5]: #T1 [6]: #F2 [7]: pending:yes