Comparable post-relapse outcomes between haploidentical and matched related donor allogeneic stem cell transplantation

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We investigated the impact of donor type on post-relapse survival (PRS) in 85 patients with hematological relapse after their first allogeneic hematological stem cell transplantation (allo-HSCT) for hematological malignancy. The median follow-up was 64 months among survivors. Both 3-year overall survival and 3-year PRS were similar in haploidentical donor (HID) and matched sibling donor (MRD) transplantation (13.0% ± 4.7% vs 19.4% ± 7.1%, P = 0.913 and 7.7 ± 3.9% vs 9.7 ± 5.3%, P = 0.667). Higher rates of post-relapse grade II-IV and III-IV acute GvHD (aGvHD) were observed in HID transplantation patients. A higher cumulative incidence of post-relapse extensive chronic GvHD was also observed for HID transplantation patients. Multivariate analyses confirmed that treatment including donor lymphocyte infusion (DLI), late relapse >1 year, and in first CR at transplantation were associated with superior PRS (P = 0.012, hazard ratio (HR) = 0.527 (0.320 - 0.866)); P = 0.033, HR = 0.534 (0.300 - 0.952) and P = 0.046, HR = 0.630 (0.400 - 0.992). The data suggest that post-relapse outcomes are comparable in HID and MRD transplantation, and that DLI is safe for relapsed patients after haploidentical transplantation.

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