• José I Trucco, Mariano Berro, Ana Lisa Basquiera, Pablo García, Sebastián Yantorno, Silvina Palmer, Alejandro Requejo, Adriana Vitriú, Gonzalo Bentolila, María Marta Rivas, Gonzalo Ferini, Juan José García, Jorge Milone, German Stemmelin, Gregorio Jaimovich, Cecilia Foncuberta, Juliana Martínez Rolón, Gustavo D Kusminsky, and GATMO-TC (Grupo Argentino de Trasplante de Médula ósea y Terapia Celular).
• Hospital Universitario Austral, Argentina. E-mail: jtrucco@cas.austral.edu.ar.
• Medicina (B Aires). 2020 Jan 1; 80 (6): 654-662.

AbstractWe retrospectively analyzed 570 adult patients who received allogeneic stem cell transplantation for malignant diseases. The outcomes were compared according to donor type. Most of the patients (60%) were transplanted for acute leukemia. Median follow-up was 1.6 years. Haploidentical allogeneic stem cell transplantation was more frequently performed for acute myeloid leukemia and in late stages than any other donor type. Non-relapse mortality at 100 days and one year for unrelated and haploidentical donors were similar, 19%-29% vs. 17%-28%, respectively. A significant better non-relapse mortality was observed for matched sibling donors (7%-15%; p < 0.001). Relapse rate was higher in haploidentical donors compared to matched sibling and unrelated donors (three year relapse rate 46%, 39%, 28%; respectively p < 0.001). Haploidentical donors resulted in lower three year progression-free survival and worse 3 year overall survival (32%; p < 0.001 and 42%; p < 0.001) compared with other donors (44% and 55% MSD, 40% and 42% UD, respectively). The incidence of grade II-IV acute graft-versus-host disease was higher in unrelated donors (51% unrelated, 35% haploidentical, 36% matched sibling; respectively; p = 0.001), with no difference in grades III-IV (p = 0.73) or in chronic graft-versus-host disease (p = 0.2) between groups. After multivariate analysis, haploidentical and unrelated donors remained negatively associated with non-relapse mortality (HR 1.95; 95% CI 1.10-3.20 and HR 2.70; 95% CI 1.63-4.46, respectively). Haploidentical donors were associated with a higher risk of relapse and worse overall survival. This analysis shows that haploidentical donors were associated with similar non-relpase mortality and higher relapse rates than unrelated donors. Better results in non-relapse mortality were observed for matched sibling donors.

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