Peripheral blood stem cell transplantation from haploidentical related donor could achieve satisfactory clinical outcomes for intermediate- or high-risk adult acute myeloid leukemia patients

feature-image

Play all audios:

Loading...

ABSTRACT Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the most important curative method for intermediate- and high-risk adult acute myeloid leukemia (AML) patients. We


aimed to identify the clinical outcomes of haploidentical related donor (HID) peripheral blood stem cell transplantation (PBSCT) who receiving peripheral blood (G-PB) harvest, and the


patients receiving bone marrow (BM) plus G-PB harvest (BM + PB) as grafts were enrolled as control. The engraftments of neutrophil and platelet in G-PB group were both faster than those in


BM + PB group. The cumulative incidences of grade II–IV acute graft-versus-host disease (aGVHD), and moderate to severe chronic GVHD (cGVHD) were all comparable between G-PB and BM + PB


groups. The cumulative incidence of relapse and non-relapse mortality at 3 years after HID HSCT was 12.6% versus 13.7% (_p_ = 0.899) and 3.6% versus 7.3% (_p_ = 0.295), respectively, in G-PB


and BM + PB group. While the probabilities of GVHD-free/relapse-free survival, leukemia-free survival, and overall survival at 3 years after HID HSCT were 60.6% versus 53.4% (_p_ = 0.333),


83.8% versus 79.0% (_p_ = 0.603), and were 87.3% versus 82.9% (_p_ = 0.670), respectively. We confirmed the safety and efficacy of HID PBSCT in intermediate- and high-risk AML patients in a


large cohort. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe


to this journal Receive 12 print issues and online access $259.00 per year only $21.58 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF


Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact


customer support SIMILAR CONTENT BEING VIEWED BY OTHERS COMPARISON OF CLINICAL OUTCOMES BETWEEN PERIPHERAL BLOOD STEM CELLS AND PERIPHERAL BLOOD STEM CELLS PLUS BONE MARROW IN


MYELODYSPLASTIC SYNDROME PATIENTS WITH HAPLOIDENTICAL TRANSPLANTATION Article 05 November 2022 PERIPHERAL BLOOD STEM CELL TRANSPLANTATION USING HLA-HAPLOIDENTICAL DONOR WITH POST-TRANSPLANT


CYCLOPHOSPHAMIDE VERSUS HLA-MATCHED SIBLING DONOR FOR LYMPHOMA Article 14 February 2024 HAPLOIDENTICAL TRANSPLANTATION WITH POST-TRANSPLANT CYCLOPHOSPHAMIDE VERSUS SINGLE CORD BLOOD


TRANSPLANTATION IN ADULTS WITH RELAPSED/REFRACTORY NON-HODGKIN LYMPHOMA Article 25 September 2024 DATA AVAILABILITY The dataset supporting the conclusions of this article is available in the


clinical data repository of Peking University People’s Hospital. Individual participant data were not shared. For the original data, please contact moxiaodong@pkuph.edu.cn. REFERENCES * Lv


M, Shen M, Mo X. Development of allogeneic hematopoietic stem cell transplantation in 2022: regenerating “Groot” to heal the world. Innovation. 2023;4:100373.


https://doi.org/10.1016/j.xinn.2023.100373. Article  PubMed  PubMed Central  Google Scholar  * Zhang XH, Chen J, Han MZ, Huang H, Jiang EL, Jiang M, et al. The consensus from the Chinese


Society of Hematology on indications, conditioning regimens and donor selection for allogeneic hematopoietic stem cell transplantation: 2021 update. J Hematol Oncol. 2021;14:145.


https://doi.org/10.1186/s13045-021-01159-2. Article  PubMed  PubMed Central  Google Scholar  * Xu LP, Lu DP, Wu DP, Jiang EL, Liu DH, Huang H, et al. Hematopoietic stem cell transplantation


activity in China 2020-2021 during the SARS-CoV-2 pandemic: a report from the Chinese Blood and Marrow Transplantation Registry Group. Transplant Cell Ther. 2023;29:136.e131–7.


https://doi.org/10.1016/j.jtct.2022.11.011. Article  CAS  Google Scholar  * Xu LP, Lu PH, Wu DP, Sun ZM, Liu QF, Han MZ, et al. Hematopoietic stem cell transplantation activity in China


2019: a report from the Chinese Blood and Marrow Transplantation Registry Group. Bone Marrow Transplant. 2021;56:2940–7. https://doi.org/10.1038/s41409-021-01431-6. Article  PubMed  PubMed


Central  Google Scholar  * Huang XJ, Zhu HH, Chang YJ, Xu LP, Liu DH, Zhang XH, et al. The superiority of haploidentical related stem cell transplantation over chemotherapy alone as


postremission treatment for patients with intermediate- or high-risk acute myeloid leukemia in first complete remission. Blood. 2012;119:5584–90.


https://doi.org/10.1182/blood-2011-11-389809. Article  CAS  PubMed  Google Scholar  * Wang Y, Liu QF, Xu LP, Liu KY, Zhang XH, Ma X, et al. Haploidentical vs identical-sibling transplant for


AML in remission: a multicenter, prospective study. Blood. 2015;125:3956–62. https://doi.org/10.1182/blood-2015-02-627786. Article  CAS  PubMed  Google Scholar  * Ma YR, Xu LP, Zhang XH,


Liu KY, Chang YJ, Lv M, et al. Allogeneic hematopoietic stem cell transplantation for intermediate-risk acute myeloid leukemia in the first remission: outcomes using haploidentical donors


are similar to those using matched siblings. Ann Hematol. 2021;100:555–62. https://doi.org/10.1007/s00277-020-04359-x. Article  CAS  PubMed  Google Scholar  * Bensinger WI, Martin PJ, Storer


B, Clift R, Forman SJ, Negrin R, et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers. N Engl J


Med. 2001;344:175–81. Article  CAS  PubMed  Google Scholar  * Couban S, Simpson DR, Barnett MJ, Bredeson C, Hubesch L, Howson-Jan K, et al. A randomized multicenter comparison of bone marrow


and peripheral blood in recipients of matched sibling allogeneic transplants for myeloid malignancies. Blood. 2002;100:1525–31. Article  CAS  PubMed  Google Scholar  * Friedrichs B,


Tichelli A, Bacigalupo A, Russell NH, Ruutu T, Shapira MY, et al. Long-term outcome and late effects in patients transplanted with mobilised blood or bone marrow: a randomised trial. Lancet


Oncol. 2010;11:331–8. Article  PubMed  Google Scholar  * Jo T, Arai Y, Kondo T, Mizuno S, Hirabayashi S, Inamoto Y, et al. Advantages of peripheral blood stem cells from unrelated donors


versus bone marrow transplants in outcomes of adult acute myeloid leukemia patients. Cytotherapy. 2022;24:1013–25. https://doi.org/10.1016/j.jcyt.2022.05.009. Article  PubMed  Google Scholar


  * Wang Y, Liu DH, Liu KY, Xu LP, Zhang XH, Han W, et al. Long-term follow-up of haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for the treatment


of leukemia: nine years of experience at a single center. Cancer. 2013;119:978–85. https://doi.org/10.1002/cncr.27761. Article  PubMed  Google Scholar  * Huang XJ, Liu DH, Liu KY, Xu LP,


Chen H, Han W, et al. Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies. Bone Marrow Transplant.


2006;38:291–7. https://doi.org/10.1038/sj.bmt.1705445. Article  PubMed  Google Scholar  * Xu LP, Wu DP, Han MZ, Huang H, Liu QF, Liu DH, et al. A review of hematopoietic cell transplantation


in China: data and trends during 2008-2016. Bone Marrow Transplant. 2017;52:1512–8. https://doi.org/10.1038/bmt.2017.59. Article  CAS  PubMed  Google Scholar  * Zhao X, Gao F, Zhang X, Wang


Y, Xu L, Liu K, et al. Improved clinical outcomes of rhG-CSF-mobilized blood and marrow haploidentical transplantation compared to propensity score-matched rhG-CSF-primed peripheral blood


stem cell haploidentical transplantation: a multicenter study. Sci China Life Sci. 2016;59:1139–48. https://doi.org/10.1007/s11427-016-0014-8. Article  CAS  PubMed  Google Scholar  * Xu LP,


Liu KY, Liu DH, Chen H, Han W, Chen YH, et al. The inferiority of G-PB to rhG-CSF-mobilized blood and marrow grafts as a stem cell source in patients with high-risk acute leukemia who


underwent unmanipulated HLA-mismatched/haploidentical transplantation: a comparative analysis. Bone Marrow Transplant. 2010;45:985–92. https://doi.org/10.1038/bmt.2009.311. Article  CAS 


PubMed  Google Scholar  * Ma YR, Zhang X, Xu L, Wang Y, Yan C, Chen H, et al. G-CSF-primed peripheral blood stem cell haploidentical transplantation could achieve satisfactory clinical


outcomes for acute leukemia patients in the first complete remission: a registered study. Front Oncol. 2021;11:631625. https://doi.org/10.3389/fonc.2021.631625. Article  PubMed  PubMed


Central  Google Scholar  * Mo XD, Zhang YY, Zhang XH, Xu LP, Wang Y, Yan CH, et al. The role of collateral related donors in haploidentical hematopoietic stem cell transplantation. Sci Bull.


2018;63:1376–82. https://doi.org/10.1016/j.scib.2018.08.008. Article  Google Scholar  * Ma R, Huang XJ, Xu LP, Liu KY, Zhang XH, Yan CH, et al. Comparable outcomes after hematopoietic stem


cell transplantation from mother donors and matched unrelated donors in patients with hematopoietic malignancies. Biol Blood Marrow Transplant. 2019;25:1210–7.


https://doi.org/10.1016/j.bbmt.2019.01.030. Article  PubMed  Google Scholar  * Wang Y, Liu QF, Lin R, Yang T, Xu YJ, Mo XD, et al. Optimizing antithymocyte globulin dosing in haploidentical


hematopoietic cell transplantation: long-term follow-up of a multicenter, randomized controlled trial. Sci Bull. 2021;66:2498–505. https://doi.org/10.1016/j.scib.2021.06.002. Article  CAS 


Google Scholar  * Mo XD, Hong SD, Zhao YL, Jiang EL, Chen J, Xu Y, et al. Basiliximab for steroid-refractory acute graft-versus-host disease: a real-world analysis. Am J Hematol.


2022;97:458–69. https://doi.org/10.1002/ajh.26475. Article  CAS  PubMed  Google Scholar  * Shen MZ, Hong SD, Lou R, Chen RZ, Zhang XH, Xu LP, et al. A comprehensive model to predict severe


acute graft-versus-host disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation. Exp Hematol Oncol. 2022;11:25.


https://doi.org/10.1186/s40164-022-00278-x. Article  PubMed  PubMed Central  Google Scholar  * Fan S, Hong HY, Dong XY, Xu LP, Zhang XH, Wang Y, et al. Machine learning algorithm as a


prognostic tool for Epstein-Barr virus reactivation after haploidentical hematopoietic stem cell transplantation. Blood Sci. 2023;5:51–9. https://doi.org/10.1097/bs9.0000000000000143.


Article  PubMed  Google Scholar  * Shen MZ, Hong SD, Wang J, Zhang XH, Xu LP, Wang Y, et al. A predicted model for refractory/recurrent cytomegalovirus infection in acute leukemia patients


after haploidentical hematopoietic stem cell transplantation. Front Cell Infect Microbiol. 2022;12:862526. https://doi.org/10.3389/fcimb.2022.862526. Article  CAS  PubMed  PubMed Central 


Google Scholar  * Chang YJ, Wang Y, Liu YR, Xu LP, Zhang XH, Chen H, et al. Haploidentical allograft is superior to matched sibling donor allograft in eradicating pre-transplantation minimal


residual disease of AML patients as determined by multiparameter flow cytometry: a retrospective and prospective analysis. J Hematol Oncol. 2017;10:134.


https://doi.org/10.1186/s13045-017-0502-3. Article  CAS  PubMed  PubMed Central  Google Scholar  * Mo XD, Zhang XH, Xu LP, Wang Y, Yan CH, Chen H, et al. Salvage chemotherapy followed by


granulocyte colony-stimulating factor-primed donor leukocyte infusion with graft-vs.-host disease control for minimal residual disease in acute leukemia/myelodysplastic syndrome after


allogeneic hematopoietic stem cell transplantation: prognostic factors and clinical outcomes. Eur J Haematol. 2016;96:297–308. https://doi.org/10.1111/ejh.12591. Article  CAS  PubMed  Google


Scholar  * Shen MZ, Zhang XH, Xu LP, Wang Y, Yan CH, Chen H, et al. Preemptive interferon-α therapy could protect against relapse and improve survival of acute myeloid leukemia patients


after allogeneic hematopoietic stem cell transplantation: long-term results of two registry studies. Front Immunol. 2022;13:757002. https://doi.org/10.3389/fimmu.2022.757002. Article  CAS 


PubMed  PubMed Central  Google Scholar  * Fan S, Pan TZ, Dou LP, Zhao YM, Zhang XH, Xu LP, et al. Preemptive interferon-α therapy could prevent relapse of acute myeloid leukemia following


allogeneic hematopoietic stem cell transplantation: a real-world analysis. Front Immunol. 2023;14:1091014. https://doi.org/10.3389/fimmu.2023.1091014. Article  CAS  PubMed  PubMed Central 


Google Scholar  * Döhner H, Wei AH, Appelbaum FR, Craddock C, DiNardo CD, Dombret H, et al. Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel


on behalf of the ELN. Blood. 2022;140:1345–77. https://doi.org/10.1182/blood.2022016867. Article  CAS  PubMed  Google Scholar  * Schoemans HM, Lee SJ, Ferrara JL, Wolff D, Levine JE,


Schultz KR, et al. EBMT-NIH-CIBMTR Task Force position statement on standardized terminology & guidance for graft-versus-host disease assessment. Bone Marrow Transplant. 2018;53:1401–15.


https://doi.org/10.1038/s41409-018-0204-7. Article  PubMed  PubMed Central  Google Scholar  * Gooley TA, Leisenring W, Crowley J, Storer BE. Estimation of failure probabilities in the


presence of competing risks: new representations of old estimators. Stat Med. 1999;18:695–706. https://doi.org/10.1002/(sici)1097-0258(19990330)18:63.0.co;2-o. Article  CAS  PubMed  Google


Scholar  * Bashey A, Zhang MJ, McCurdy SR, St Martin A, Argall T, Anasetti C, et al. Mobilized peripheral blood stem cells versus unstimulated bone marrow as a graft source for


T-cell-replete haploidentical donor transplantation using post-transplant cyclophosphamide. J Clin Oncol. 2017;35:3002–9. https://doi.org/10.1200/jco.2017.72.8428. Article  CAS  PubMed 


PubMed Central  Google Scholar  * Ruggeri A, Labopin M, Bacigalupo A, Gülbas Z, Koc Y, Blaise D, et al. Bone marrow versus mobilized peripheral blood stem cells in haploidentical transplants


using posttransplantation cyclophosphamide. Cancer. 2018;124:1428–37. https://doi.org/10.1002/cncr.31228. Article  CAS  PubMed  Google Scholar  * Zhao X, Zhao X, Huo M, Fan Q, Pei X, Wang


Y, et al. Donor-specific anti-human leukocyte antigen antibodies predict prolonged isolated thrombocytopenia and inferior outcomes of haploidentical hematopoietic stem cell transplantation.


J Immunol Res. 2017;2017:1043836. https://doi.org/10.1155/2017/1043836. Article  CAS  PubMed  PubMed Central  Google Scholar  * Champlin RE, Schmitz N, Horowitz MM, Chapuis B, Chopra R,


Cornelissen JJ, et al. Blood stem cells compared with bone marrow as a source of hematopoietic cells for allogeneic transplantation. IBMTR Histocompatibility and Stem Cell Sources Working


Committee and the European Group for Blood and Marrow Transplantation (EBMT). Blood. 2000;95:3702–9. CAS  PubMed  Google Scholar  * Zhao XS, Chen Y, Zhao XY, Liu DH, Xu LP, Wang Y, et al.


Improved outcomes using G-CSF-mobilized blood and bone marrow grafts as the source of stem cells compared with G-PB after HLA-identical sibling transplantation in patients with acute


leukemia. Clin Transplant. 2013;27:844–51. https://doi.org/10.1111/ctr.12225. Article  PubMed  Google Scholar  * Mielcarek M, Storer B, Martin PJ, Forman SJ, Negrin RS, Flowers ME, et al.


Long-term outcomes after transplantation of HLA-identical related G-CSF-mobilized peripheral blood mononuclear cells versus bone marrow. Blood. 2012;119:2675–8.


https://doi.org/10.1182/blood-2011-12-396275. Article  CAS  PubMed  PubMed Central  Google Scholar  * Mo XD, Xu LP, Zhang XH, Liu DH, Wang Y, Chen H, et al. Chronic GVHD induced GVL effect


after unmanipulated haploidentical hematopoietic SCT for AML and myelodysplastic syndrome. Bone Marrow Transplant. 2015;50:127–33. https://doi.org/10.1038/bmt.2014.223. Article  PubMed 


Google Scholar  * Xiao-Jun H, Lan-Ping X, Kai-Yan L, Dai-Hong L, Yu W, Huan C, et al. Partially matched related donor transplantation can achieve outcomes comparable with unrelated donor


transplantation for patients with hematologic malignancies. Clin Cancer Res. 2009;15:4777–83. https://doi.org/10.1158/1078-0432.CCR-09-0691. Article  PubMed  Google Scholar  Download


references ACKNOWLEDGEMENTS We sincerely thank all participating patients, The authors appreciate Dr. Qi Wen, Feng-Ting Dao, Dao-Xing Deng, Shuang Fan, Ze Guo, and Meng-Zhu Shen for their


help in data collection. FUNDING This work was supported by the National Key Research and Development Program of China (2022YFA1103300, 2022YFC2502606), Major Program of the National Natural


Science Foundation of China (82293630), the Key Program of the National Natural Science Foundation of China (81930004), the National Natural Science Foundation of China (82170208,


82200239), and CAMS Innovation Fund for Medical Sciences (2019-I2M-5-034, 2022-I2M-C&T-B-121), Peking University People’s Hospital Research and Development Funds (RZ2022-02), and the


Fundamental Research Funds for the Central Universities. AUTHOR INFORMATION Author notes * These authors contributed equally: Le-Qing Cao, Wen-Xuan Huo. AUTHORS AND AFFILIATIONS * Peking


University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell


Transplantation, Beijing, China Le-Qing Cao, Wen-Xuan Huo, Xiao-Hui Zhang, Lan-Ping Xu, Yu Wang, Chen-Hua Yan, Huan Chen, Yu-Hong Chen, Wei Han, Feng-Rong Wang, Jing-Zhi Wang, Xiao-Jun Huang


 & Xiao-Dong Mo * Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China Xiao-Jun Huang * Research Unit of Key


Technique for Diagnosis and Treatments of Hematologic Malignancies (2019RU029), Chinese Academy of Medical Sciences, Beijing, China Xiao-Jun Huang & Xiao-Dong Mo Authors * Le-Qing Cao


View author publications You can also search for this author inPubMed Google Scholar * Wen-Xuan Huo View author publications You can also search for this author inPubMed Google Scholar *


Xiao-Hui Zhang View author publications You can also search for this author inPubMed Google Scholar * Lan-Ping Xu View author publications You can also search for this author inPubMed Google


Scholar * Yu Wang View author publications You can also search for this author inPubMed Google Scholar * Chen-Hua Yan View author publications You can also search for this author inPubMed 


Google Scholar * Huan Chen View author publications You can also search for this author inPubMed Google Scholar * Yu-Hong Chen View author publications You can also search for this author


inPubMed Google Scholar * Wei Han View author publications You can also search for this author inPubMed Google Scholar * Feng-Rong Wang View author publications You can also search for this


author inPubMed Google Scholar * Jing-Zhi Wang View author publications You can also search for this author inPubMed Google Scholar * Xiao-Jun Huang View author publications You can also


search for this author inPubMed Google Scholar * Xiao-Dong Mo View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS X-DM and X-JH conceived and


designed the study. L-QC and W-XH collected and analyzed data as well as drafted the manuscript. All the authors contributed to samples collected and provided feedback on the data.


CORRESPONDING AUTHOR Correspondence to Xiao-Dong Mo. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing interests. ETHICS APPROVAL AND CONSENT TO PARTICIPATE The study


was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Institutional Review Board of Peking University People’s Hospital. CONSENT FOR PUBLICATION


Consent for publication was obtained from the patient. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature remains neutral with regard to jurisdictional claims in published maps and


institutional affiliations. SUPPLEMENTARY INFORMATION SUPPLEMENTAL APPENDIX RIGHTS AND PERMISSIONS Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to


this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the


terms of such publishing agreement and applicable law. Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Cao, LQ., Huo, WX., Zhang, XH. _et al._ Peripheral blood stem cell


transplantation from haploidentical related donor could achieve satisfactory clinical outcomes for intermediate- or high-risk adult acute myeloid leukemia patients. _Bone Marrow Transplant_


59, 203–210 (2024). https://doi.org/10.1038/s41409-023-02117-x Download citation * Received: 19 May 2023 * Revised: 18 September 2023 * Accepted: 26 September 2023 * Published: 15 November


2023 * Issue Date: February 2024 * DOI: https://doi.org/10.1038/s41409-023-02117-x SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get


shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative