TY - JOUR T1 - Unmanipulated haploidentical in comparison with matched unrelated donor stem cell transplantation in patients 60 years and older with acute myeloid leukemia: a comparative study on behalf of the ALWP of the EBMT. AU - Santoro,Nicole, AU - Labopin,Myriam, AU - Giannotti,Federica, AU - Ehninger,Gerard, AU - Niederwieser,Dietger, AU - Brecht,Arne, AU - Stelljes,Matthias, AU - Kröger,Nicolaus, AU - Einsele,Herman, AU - Eder,Matthias, AU - Hallek,Michael, AU - Glass,Bertram, AU - Finke,Jürgen, AU - Ciceri,Fabio, AU - Mohty,Mohamad, AU - Ruggeri,Annalisa, AU - Nagler,Arnon, Y1 - 2018/04/16/ PY - 2018/02/16/received PY - 2018/03/29/accepted PY - 2018/4/18/entrez PY - 2018/4/18/pubmed PY - 2019/10/28/medline KW - Acute myeloid leukemia KW - Allogeneic stem cell transplantation KW - Elderly KW - Haploidentical KW - MUD SP - 55 EP - 55 JF - Journal of hematology & oncology JO - J Hematol Oncol VL - 11 IS - 1 N2 - BACKGROUND: Acute myeloid leukemia (AML) is both more common and with more biologically aggressive phenotype in the elderly. Allogenic stem cell transplantation (allo-SCT) is the best treatment option in fit patients. Either HLA-matched unrelated donor (MUD) or haploidentical (Haplo) donor are possible alternative for patients in need. METHODS: We retrospectively compared non-T-cell-depleted Haplo (n = 250) to 10/10 MUD (n = 2589) in AML patients ≥ 60 years. RESULTS: Median follow-up was 23 months. Disease status at transplant differs significantly between the two groups (p < 10-4). Reduced intensity conditioning (RIC) was administrated to 73 and 77% of Haplo and MUD, respectively (p = 0.23). Stem cell source was the bone marrow (BM) in 52% of the Haplo and 6% of MUD (p < 10-4). Anti-thymocyte globulin (ATG) was most frequently used in MUD (p < 10-4) while post-Tx cyclophosphamide (PT-Cy) was given in 62% of Haplo. Engraftment was achieved in 90% of the Haplo vs 97% of MUD (p < 10-4). In multivariate analysis, no significant difference was found between Haplo and MUD for acute (a)graft versus host disease (GVHD) grade II-IV, relapse incidence (RI), non-relapse mortality (NRM), leukemia free survival (LFS), graft-versus-host-free-relapse free survival (GRFS), and overall survival (OS). Extensive chronic (c)GVHD was significantly higher for MUD as compared to Haplo (HR 2, p = 0.01, 95% CI 1.17-3.47). A propensity score analysis confirmed the higher risk of extensive cGVHD for MUD without differences for other outcomes. CONCLUSIONS: Allo-SCT from both Haplo and MUD are valid option for AML patients ≥ 60 years of age with similar results. Transplantation from MUD was associated with higher extensive cGVHD. Our findings suggest that Haplo is a suitable and attractive graft source for patients≥ 60 with AML in need of allo-SCT. SN - 1756-8722 UR - https://www.unboundmedicine.com/medline/citation/29661208/Unmanipulated_haploidentical_in_comparison_with_matched_unrelated_donor_stem_cell_transplantation_in_patients_60_years_and_older_with_acute_myeloid_leukemia:_a_comparative_study_on_behalf_of_the_ALWP_of_the_EBMT_ L2 - https://jhoonline.biomedcentral.com/articles/10.1186/s13045-018-0598-0 DB - PRIME DP - Unbound Medicine ER -