Advances in Hematology / 2016 / Article / Tab 1 / Review Article
Review on Haploidentical Hematopoietic Cell Transplantation in Patients with Hematologic Malignancies Table 1 Comparative summary of haploidentical (HAPLO) versus matched sibling donor (MSD), matched-unrelated donor (MUD), and unrelated cord blood (UCB) hematopoietic stem cell transplantation outcomes in patients with acute myelogenous leukemia (AML).
HAPLO MSD MUD UCB Donor availability [3 ] (~50–70%) (~15–20%) (~20–30%) (~50%) Time to transplant (~10–20 days) (~10–20 days) (~2–12 months) (~2–4 weeks) Stem cell dose (CD34+/kg) [4 , 5 ] ~6–8 × 106 ~6–8 × 106 ~6–8 × 106 ~3–5 × 105 Days to engraftment [6 ] ( ) 18 d 18 d 17 d 23 d Acute GVHD, cumulative Grades 2–4 ( ) [6 ] 14% 31% 21% 19% Grades 3-4 ( ) [6 ] 4% 7% 3% 1% Grades 3-4 ( ) [7 ] 10% 3% — — Grades 3-4, myeloablative conditioning ( ) [8 ] 7% — 13% — Grades 3-4, reduced intensity conditioning ( ) [8 ] 2% — 11% — Chronic GVHD Cumulative, moderate-severe ( ) [6 ] 15% 29% 22% 23% Cumulative, at 1 year, severe ( ) [7 ] 12% 2% — — Myeloablative conditioning, at 36 months ( ) [8 ] 30% — 53% — Reduced intensity conditioning, at 36 months ( ) [8 ] 34% — 52% — Relapse rate 3 y, cumulative ( ) [7 ] 15% 15% — — 4 y, cumulative ( ) [6 ] 35% 40% 23% 30% Early disease (CR1, CR2) ( ) [6 ] 18% 36% 20% 24% Advanced disease (>CR2) ( ) [6 ] 47% 47% 28% 40% Disease-free survival Cumulative 3 y DFS ( ) [7 ] 74% 78% — — Cumulative 4 y DFS ( ) [6 ] 43% 32% 36% 33% Overall survival 3 y OS ( ) [7 ] 79% 82% — — 4 y OS ( ) [6 ] 52% 45% 43% 34% Relapse-related mortality [6 ] 26% ( ) 26% ( ) 21% ( ) 29% ( ) Transplantation-related mortality ( ) [6 ] 18% 24% 33% 35% Immune reconstitution: CD4+ count at posttransplant day +100 ( ) [6 ]
190/μ L 229/μ L 106/μ L 63/μ L Cumulative incidence of CMV antigenemia ( ) [6 ] 74% 58% 60% 68% Infection incidence at posttransplant day +100 [6 ] Bacterial 25% 23% 36% 39% Fungal 11% 4% 14% 14% Rate of fatal infections [6 ] 11% ( ) 4% ( ) 14% ( ) 17% ( )
Data obtained from retrospective comparative studies by Raiola et al. [6 ], Ciurea et al. [8 ], and Gragert et al. [3 ] and a prospective study by Wang et al. [7 ]. The prospective study by Wang et al. [7 ] was the only one which used the same GVHD regimen for both the HAPLO and the MSD groups. ~: approximate; 3 y: 3 years; 4 y: 4 years; CR1: first complete remission; CR2: second complete remission; DFS: disease-free survival; OS: overall survival.