Review Article

Comparable Outcomes for Hematologic Malignancies after HLA-Haploidentical Transplantation with Posttransplantation Cyclophosphamide and HLA-Matched Transplantation

Table 1

Summary of included studies.

StudyDiseaseHLA type and patient numberConditioning regimensGVHD prophylaxisGraft source

McCurdy et al.
Blood 2015 [11]
Hematologic malignanciesHaplo Haplo:
Flu 30 mg/m2 D-6–2
Cy 14.5 mg/kg D-6-5
TBI 200 cGY D-1
Haplo: PTCy 50 mg/kg D3 and D4,
MMF D5–35,
Tac D5–90 or 180
BM
Historical MRD or MUD cohort MRD/MUD:
Flu 120 mg/m2
Bu 3.2–6.4 IV mg/kg
ATG
MRD/MUD:
CNI + MTX sirolimus
or
CSP with MMF
BM or PBSC

Ciurea et al.
Blood 2015 [6]
AMLMUD MAC:
TBI/Cy
MUD:
CNI + MTX
or
MMF
PBSC > BM
Haplo TBI/Flu
Bu/Cy
Mel/Thiotepa/Flu
Bu/Flu
Bu/Flu/ATG
Bu/Thiotepa/Flu
NMA:
Flu/Cy/TBI
Haplo:
PTCy 50 mg/kg D3 and D4, MMF, and CNI
BM > PBSC

Bashey et al.
BBMT [7]
Hematologic malignanciesMRD
MUD
MRD or MUD:
Bu/Cy
MRD or MUD:
Tac + MTX ATG alemtuzumab
PBSC ≫ BM
Haplo Flu/Bu
Flu/Bu/Cy
Flu/Mel
Etop/TBI
Flu/Cy
Flu/Cy/TBI
Cy/TBI
Mel/TBI
Flu/TBI
Bu/Cy/Etop
NMA haplo:
Flu/Cy/TBI
MAC haplo:
Flu/Bu/Cy
Flu/TBI
Haplo:
PTCy 50 mg/kg D3 and D4, MMF, and CNI
NMA haplo:
BM ≫ PBSC
MAC haplo: PBSC only

Raiola et al.
BBMT 2014 [3]
Hematologic malignanciesMRD
MUD
mmUD
UCB
Haplo
MAC:
Thio/Bu/Flu
Bu/Cy
Flu/TBI
Cy/TBI
RIC:
Flu/Cy/TBI
Thio/Cy Mel
MRD: CSP + mini-MTX
MUD: CSP + mini-MTX + ATG
UCB: CSP + MMF + ATG
Haplo: PTCy 50 mg/kg D3 and D4 + CSP + MMF
BM
PBSC
UCB

Bashey et al.
JCO 2013 [5]
Hematologic malignanciesMRD
MUD
RIC or MACStandard regimensPBSC or BM
Haplo NMA haplo:
Flu 30 mg/m2 D-6–2
Cy 14.5 mg/kg D-6-5
TBI 200 cGY D-1
or
Haplo: PTCy 50 mg/kg D3 and D4, MMF D5–35, and Tac D5–180 BM for NMA
MAC haplo: Flu 25 mg/m2 D-6–2,
Bu 110–130 mg/m2 IV
D-7–4,
Cy 14.5 mg/kg D-3-2
PBSC for MAC

Di Stasi et al.
BBMT 2014 [4]
AML or MDSMRD
MUD
MRD/MUD:
Flu 120–160 mg/m2 in 4 daily doses
Mel 140 mg/m2 or 100 mg/m2
MRD: Tac + mini-MTX
MUD: Tac + mini-MTX + ATG
BM or PBSC
Haplo Haplo: above + thiotepa 5–10 mg/kg Haplo:
PTCy 50 mg/kg D3 and D4,
MMF D5–100,
Tac D5–180
BM or PBSC

Kanakry et al.
BBMT 2013 [10]
Peripheral T-cell lymphomaMRD Bu/CyMRD: CSP
or
PTCy 50 mg/kg D3 and D4
MMF Tac
Haplo Cy/TBI
Flu/TBI
Bu/Flu
Flu/Cy/TBI
Fly/Cy/TBI
Bu/Cy
Cy/TBI
Haplo:
PTCy 50 mg/kg D3 and D4,
MMF, Tac, or CSP
BM (1 PBSC)

Burroughs et al.
BBMT 2008 [2]
Hodgkin lymphomaMRD
MUD
MRD/MUD:
TBI 2 Gy
TBI 2 Gy + Flu 30 mg/m2 days 4–2
MRD/MUD:
MMF
or
CNI
PBSC
Haplo Haplo:
Flu 30 mg/m2 D-6–2
Cy 14.5 mg/kg D-6-5
TBI 200 cGY D-1
Haplo:
PTCy 50 mg/kg D3 (D4),
MMF D4 or 5–35,
Tac D4, or 5–180
BM

HLA: human leukocyte antigen; GVHD: graft-versus-host disease; haplo: HLA-haploidentical; : number; MRD: HLA-matched related donor; MUD: HLA-matched unrelated donor; Flu: fludarabine; D: day; Cy: cyclophosphamide; TBI: total body irradiation; Bu: busulfan; ATG: antithymocyte globulin; PTCy: posttransplantation cyclophosphamide; MMF: mycophenolate mofetil; Tac: tacrolimus; CNI: calcineurin inhibitor; MTX: methotrexate; CSP: cyclosporine; BM: bone marrow; PBSC: peripheral blood stem cells; AML: acute myelogenous leukemia; MAC: myeloablative conditioning; Mel: melphalan; BBMT: biology of blood and marrow transplantation; Etop: etoposide; NMA: nonmyeloablative; mmUD: HLA-mismatched unrelated donor; UCB: umbilical cord blood; JCO: Journal of Clinical Oncology; MDS: myelodysplastic syndrome.
Armand et al. [12], a disease risk index for patients undergoing allogeneic stem cell transplantation, July 2012; Blood: 120 (4) 905–913.