Haploidentical HCT is Safe and Effective for Older Patients with AML/MDS

Haploidentical hematopoietic cell transplantation (HCT) is an appropriate therapy for older adults with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS), and can result in a 2-year progression-free survival (PFS) of 74% in selected patients.

In this single-center study of 43 patients (median age 61 years) with AML/MDS, all recipients received reduced-intensity conditioning and post-transplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis.

Two-year survival and other patient outcomes are shown in the table below.

 Outcome Incidence
 2-year overall survival 42%
 2-year progression-free survival 42%
 2-year relapse 24%
 Grade II-IV acute GVHD at 6 months 35%
 Grade III-IV acute GVHD at 6 months 5%
 Chronic GVHD at 2 years 9%

Predictors of the highest level of 2-year PFS of 74% were associated with intermediate/good-risk cytogenetics, in first or second remission (HR: 0.4, p=0.05) and with a younger donor (≤40 years) (HR: 0.2, p=0.01).

The researchers concluded that haploidentical transplantation is safe and effective for older AML/MDS patients and that best outcomes are achieved in patients with good/intermediate cytogenetics, in remission at the time of HCT and have a child 40 years or younger as a donor.

Ciurea SO, et al. Biol Blood Marrow Transplant

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