Given the dismal prognosis for patients with TP53-mutated acute myeloid leukemia (AML), the optimal donor for those undergoing allogeneic hematopoietic cell transplantation (allo-HCT) remains unclear. We retrospectively analyzed adult patients with TP53-mutated AML who underwent first allo-HCT in CR1 between 2010 and 2021. Outcomes were compared among using a haploidentical donor (Haplo), a matched sibling donor (MSD), and a 10/10 matched unrelated donor (MUD). The analysis comprised 451 patients, including 86 Haplo, 117 MSD, and 248 MUD. Patients in the three groups were transplanted during a similar period. Haplo, MSD, and MUD groups experienced similar incidences of Day 180 Grades II–IV aGVHD (30.9% vs. 23.6% vs. 28.3%), Grades III–IV aGVHD (13.6% vs. 10.1% vs. 9.1%), 2-year cGVHD (28.9.% vs. 30.9% vs. 25.6%) and extensive cGVHD (10.9% vs. 16.1% vs. 13.3%). By multivariate analysis, the outcomes were similar in the three groups. The MSD group was associated with a similar 2-year overall survival (OS: 33.9%; p = 0.799), leukemia-free survival (LFS: 30.5%; p = 0.956), relapse incidence (RI: 54.2%; p = 0.497), non-relapse mortality (NRM: 15.3%; p = 0.368), and GVHD-free, relapse-free survival (GRFS: 21.8%, p = 0.957) when compared with the Haplo group (2-year OS: 46.7%, LFS: 37.4%, RI: 40.8%, NRM: 21.7%, GRFS: 25.7%). The MUD group also experienced a similar 2-year OS (36.9%; p = 0.892), LFS (31%; p = 0.904), RI (50.8%; p = 0.521), NRM (18.2%; p = 0.368) and GRFS (21.9%; p = 0.383) when compared with the Haplo group. In conclusion, outcomes of patients with TP53-mutated AML undergoing allo-HCT from a haploidentical donor were comparable to those from an MSD or 10/10 MUD HCT.
Similar Outcome With Haploidentical, Matched Sibling, or Matched Unrelated Donor Hematopoietic Cell Transplantation for Adult Patients With Adverse-Risk TP53-Mutated Acute Myeloid Leukemia in First Remission: A Comparative Study From the Global Committee and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation / Ru, Y., Chen, J., Ferhat, A.-T., Labussiere-Wallet, H., Gedde-Dahl, T., Kroger, N., Socie, G., Yakoub-Agha, I., Eder, M., Mielke, S., Wu, D., Mohty, M., Ciceri, F., Gorin, N.-C.. - In: AMERICAN JOURNAL OF HEMATOLOGY. - ISSN 0361-8609. - 100:12(2025), pp. 2220-2229. [10.1002/ajh.70069]
Similar Outcome With Haploidentical, Matched Sibling, or Matched Unrelated Donor Hematopoietic Cell Transplantation for Adult Patients With Adverse-Risk TP53-Mutated Acute Myeloid Leukemia in First Remission: A Comparative Study From the Global Committee and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Ciceri F.;
2025-01-01
Abstract
Given the dismal prognosis for patients with TP53-mutated acute myeloid leukemia (AML), the optimal donor for those undergoing allogeneic hematopoietic cell transplantation (allo-HCT) remains unclear. We retrospectively analyzed adult patients with TP53-mutated AML who underwent first allo-HCT in CR1 between 2010 and 2021. Outcomes were compared among using a haploidentical donor (Haplo), a matched sibling donor (MSD), and a 10/10 matched unrelated donor (MUD). The analysis comprised 451 patients, including 86 Haplo, 117 MSD, and 248 MUD. Patients in the three groups were transplanted during a similar period. Haplo, MSD, and MUD groups experienced similar incidences of Day 180 Grades II–IV aGVHD (30.9% vs. 23.6% vs. 28.3%), Grades III–IV aGVHD (13.6% vs. 10.1% vs. 9.1%), 2-year cGVHD (28.9.% vs. 30.9% vs. 25.6%) and extensive cGVHD (10.9% vs. 16.1% vs. 13.3%). By multivariate analysis, the outcomes were similar in the three groups. The MSD group was associated with a similar 2-year overall survival (OS: 33.9%; p = 0.799), leukemia-free survival (LFS: 30.5%; p = 0.956), relapse incidence (RI: 54.2%; p = 0.497), non-relapse mortality (NRM: 15.3%; p = 0.368), and GVHD-free, relapse-free survival (GRFS: 21.8%, p = 0.957) when compared with the Haplo group (2-year OS: 46.7%, LFS: 37.4%, RI: 40.8%, NRM: 21.7%, GRFS: 25.7%). The MUD group also experienced a similar 2-year OS (36.9%; p = 0.892), LFS (31%; p = 0.904), RI (50.8%; p = 0.521), NRM (18.2%; p = 0.368) and GRFS (21.9%; p = 0.383) when compared with the Haplo group. In conclusion, outcomes of patients with TP53-mutated AML undergoing allo-HCT from a haploidentical donor were comparable to those from an MSD or 10/10 MUD HCT.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
