PMID- 35467818
OWN - NLM
STAT- MEDLINE
DCOM- 20220623
LR  - 20220729
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Print)
IS  - 0366-6999 (Linking)
VI  - 135
IP  - 8
DP  - 2022 Apr 20
TI  - Haploidentical transplantation has a superior graft-versus-leukemia effect than 
      HLA-matched sibling transplantation for Ph- high-risk B-cell acute lymphoblastic 
      leukemia.
PG  - 930-939
LID - 10.1097/CM9.0000000000001852 [doi]
AB  - BACKGROUND: Compared with human leukocyte antigen (HLA)-matched sibling donor 
      (MSD) transplantation, it remains unclear whether haploidentical donor (HID) 
      transplantation has a superior graft-versus-leukemia (GVL) effect for 
      Philadelphia-negative (Ph-) high-risk B-cell acute lymphoblastic leukemia 
      (B-ALL). This study aimed to compare the GVL effect between HID and MSD 
      transplantation for Ph- high-risk B-ALL. METHODS: This study population came from 
      two prospective multicenter trials (NCT01883180, NCT02673008). Immunosuppressant 
      withdrawal and prophylactic or pre-emptive donor lymphocyte infusion (DLI) were 
      administered in patients without active graft-versus-host disease (GVHD) to 
      prevent relapse. All patients with measurable residual disease (MRD) positivity 
      posttransplantation (post-MRD+) or non-remission (NR) pre-transplantation 
      received prophylactic/pre-emptive interventions. The primary endpoint was the 
      incidence of post-MRD+. RESULTS: A total of 335 patients with Ph- high-risk B-ALL 
      were enrolled, including 145 and 190, respectively, in the HID and MSD groups. 
      The 3-year cumulative incidence of post-MRD+ was 27.2% (95% confidence interval 
      [CI]: 20.2%-34.7%) and 42.6% (35.5%-49.6%) in the HID and MSD groups (P = 0.003), 
      respectively. A total of 156 patients received DLI, including 60 (41.4%) and 96 
      (50.5%), respectively, in the HID and MSD groups (P = 0.096). The 3-year 
      cumulative incidence of relapse was 18.6% (95% CI: 12.7%-25.4%) and 25.9% 
      (19.9%-32.3%; P = 0.116) in the two groups, respectively. The 3-year overall 
      survival (OS) was 67.4% (95% CI: 59.1%-74.4%) and 61.6% (54.2%-68.1%; P = 0.382), 
      leukemia-free survival (LFS) was 63.4% (95% CI: 55.0%-70.7%) and 58.2% 
      (50.8%-64.9%; P = 0.429), and GVHD-free/relapse-free survival (GRFS) was 51.7% 
      (95% CI: 43.3%-59.5%) and 37.8% (30.9%-44.6%; P = 0.041), respectively, in the 
      HID and MSD groups. CONCLUSION: HID transplantation has a lower incidence of 
      post-MRD+ than MSD transplantation, suggesting that HID transplantation might 
      have a superior GVL effect than MSD transplantation for Ph- high-risk B-ALL 
      patients. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01883180, NCT02673008.
CI  - Copyright (c) 2022 The Chinese Medical Association, produced by Wolters Kluwer, 
      Inc. under the CC-BY-NC-ND license.
FAU - Fan, Menglin
AU  - Fan M
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Wang, Yu
AU  - Wang Y
AD  - Department of Hematology, Peking University People's Hospital, Peking University 
      Institute of Hematology, Beijing 100044, China.
FAU - Lin, Ren
AU  - Lin R
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Lin, Tong
AU  - Lin T
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Huang, Fen
AU  - Huang F
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Fan, Zhiping
AU  - Fan Z
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Xu, Yajing
AU  - Xu Y
AD  - Department of Hematology, Xiangya Hospital, Central South University, Changsha, 
      Hunan 110051, China.
FAU - Yang, Ting
AU  - Yang T
AD  - Department of Hematology, Fujian Institute of Hematology, Fujian Medical 
      University Union Hospital, Fuzhou, Fujian 350001, China.
FAU - Xu, Na
AU  - Xu N
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Shi, Pengcheng
AU  - Shi P
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Nie, Danian
AU  - Nie D
AD  - Department of Hematology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, 
      Guangzhou, Guangdong 510130, China.
FAU - Lin, Dongjun
AU  - Lin D
AD  - Department of Hematology, The Third Affiliated Hospital, Sun Yat-sen University, 
      Guangzhou, Guangdong 510630, China.
FAU - Jiang, Zujun
AU  - Jiang Z
AD  - Department of Hematology, Guangzhou General Hospital of Guangzhou Military 
      Command, Guangzhou, Guangdong 510010, China.
FAU - Wang, Shunqing
AU  - Wang S
AD  - Department of Hematology, Guangzhou First People's Hospital, Guangzhou, Guangdong 
      510080, China.
FAU - Sun, Jing
AU  - Sun J
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Huang, Xiaojun
AU  - Huang X
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
AD  - Department of Hematology, Peking University People's Hospital, Peking University 
      Institute of Hematology, Beijing 100044, China.
FAU - Liu, Qifa
AU  - Liu Q
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
FAU - Xuan, Li
AU  - Xuan L
AD  - Department of Hematology, Nanfang Hospital, Southern Medical University, 
      Guangzhou, Guangdong 510515, China.
LA  - eng
SI  - ClinicalTrials.gov/NCT02673008
SI  - ClinicalTrials.gov/NCT01883180
PT  - Journal Article
DEP - 20220420
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Acute Disease
MH  - *Graft vs Host Disease/epidemiology/prevention & control
MH  - HLA Antigens
MH  - Humans
MH  - Multicenter Studies as Topic
MH  - Neoplasm, Residual
MH  - *Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy
MH  - Prospective Studies
MH  - Recurrence
MH  - Retrospective Studies
MH  - Siblings
MH  - *Transplantation, Haploidentical/adverse effects/methods
PMC - PMC9276235
COIS- None.
EDAT- 2022/04/26 06:00
MHDA- 2022/06/24 06:00
PMCR- 2022/04/20
CRDT- 2022/04/25 15:32
PHST- 2022/04/26 06:00 [pubmed]
PHST- 2022/06/24 06:00 [medline]
PHST- 2022/04/25 15:32 [entrez]
PHST- 2022/04/20 00:00 [pmc-release]
AID - 00029330-202204200-00007 [pii]
AID - CMJ-2021-1883 [pii]
AID - 10.1097/CM9.0000000000001852 [doi]
PST - epublish
SO  - Chin Med J (Engl). 2022 Apr 20;135(8):930-939. doi: 10.1097/CM9.0000000000001852.