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 × 10^6	~6–8 × 10^6	~6–8 × 10^6	~3–5 × 10^5
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/μL	229/μL	106/μL	63/μL
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.