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Alternative donor transplantation for acute myeloid leukemia in patients aged ≥50 years: young HLA-matched unrelated or haploidentical donor?
- Source :
- Haematologica
- Publication Year :
- 2020
- Publisher :
- Ferrata Storti Foundation, 2020.
-
Abstract
- We sought to study whether survival after haploidentical transplantation is comparable to that after matched unrelated donor transplantation for 822 patients aged 50-75 years with acute myeloid leukemia in first or second complete remission. One hundred and ninety-two patients received grafts from haploidentical donors (sibling 25%; offspring 75%) and 631 patients from matched unrelated donors aged 18-40 years. Patients' and disease characteristics of the two groups were similar except that recipients of matched unrelated donor transplantation were more likely to have poor risk cytogenetics and more likely to receive myeloablative conditioning regimens. Time from documented remission to transplant did not differ by donor type. Five-year overall survival was 32% and 42% after haploidentical and matched unrelated donor transplant, respectively (P=0.04). Multivariable analysis showed higher mortality (hazard ratio 1.27, P=0.04) and relapse (hazard ratio 1.32, P=0.04) after haploidentical transplantation, with similar non-relapse mortality risks. Chronic graft-versus-host disease was higher after matched unrelated donor compared to haploidentical transplantation when bone marrow was the graft (hazard ratio 3.12, P
- Subjects :
- Adult
Acute Myeloid Leukemia
medicine.medical_specialty
Transplantation Conditioning
Adolescent
Offspring
Graft vs Host Disease
Human leukocyte antigen
Disease
Article
Young Adult
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Transplantation, Homologous
Humans
Sibling
Aged
Retrospective Studies
business.industry
Hazard ratio
Hematopoietic Stem Cell Transplantation
Myeloid leukemia
Hematology
Middle Aged
3. Good health
Transplantation
Leukemia, Myeloid, Acute
Editorial
medicine.anatomical_structure
surgical procedures, operative
Transplantation, Haploidentical
Bone marrow
business
Unrelated Donors
030215 immunology
Subjects
Details
- Language :
- English
- ISSN :
- 15928721 and 03906078
- Volume :
- 105
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Haematologica
- Accession number :
- edsair.doi.dedup.....f39e0bc7398f46f41ef3a4a64369cd3c