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HLA-mismatched stem cell microtransplantation compared to matched-sibling donor transplantation for intermediate/high-risk acute myeloid leukemia

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Abstract

HLA-mismatched stem cell microtransplantation is a new form of transplantation reported in recent years. We compared 59 patients undergoing microtransplantation to 66 patients undergoing HLA-matched sibling donor (MSD) transplantation at the same period from April 2012 to December 2016, who all suffered from intermediate/high-risk acute myelogenous leukemia (AML) in first complete remission (CR1). The estimated overall survival (OS) at 2 years was 74.1% ± 6.2% and 34.3% ± 7.9% in MSD and microtransplantation group, respectively (P = 0.001). The estimated leukemia-free survival (LFS) at 2 years was 73.3% ± 6.1% in the MSD group and 31.6% ± 7.6% in the microtransplantation group (P = 0.000). The 2-year cumulative incidence of relapse was 17.6% and 62.3% in the MSD and microtransplantation groups, respectively (P < 0.0001). The 2-year cumulative incidence of nonrelapse mortality was 10.9% in MSD group and 4.2% in the microtransplantation group (P = 0.251). Hematopoietic recovery time was shorter in the microtransplantation group than in the MSD group (P < 0.05). The infection rate was higher in the MSD group than in the microtransplantation group (P = 0.012). The preliminary results suggested that OS and LFS of microtransplantation were inferior to MSD transplantation for intermediate/high-risk AML in CR1.

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Funding

This work was supported by the National Key R&D Program of China (2016YFC0902800, 2017YFA0104502, 2017ZX09304021), Innovation Capability Development Project of Jiangsu Province (BM2015004), Jiangsu Provincial Key Medical Center (YXZXA2016002), Jiangsu Medical Outstanding Talents Project (JCRCA2016002), and Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).

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Author notes

  1. Limin Liu and Xingxia Zhang contributed equally to this work.

Authors and Affiliations

  1. Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People’s Republic of China

    Limin Liu, Huiying Qiu, Xiaowen Tang, Yue Han, Chengcheng Fu, Zhengming Jin, Mingqing Zhu, Miao Miao & Depei Wu

  2. Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People’s Republic of China

    Limin Liu, Huiying Qiu, Xiaowen Tang, Yue Han, Chengcheng Fu, Zhengming Jin, Mingqing Zhu, Miao Miao & Depei Wu

  3. Key Laboratory of Stem Cells and Biomedical Materials of Jiangsu Province and Chinese Ministry of Science and Technology, Suzhou, Jiangsu Province, 215006, People’s Republic of China

    Limin Liu, Huiying Qiu, Xiaowen Tang, Yue Han, Chengcheng Fu, Zhengming Jin, Mingqing Zhu, Miao Miao & Depei Wu

  4. Department of Hematology, Huai’an Hospital Affiliated to Xuzhou Medical College, Huai’an Second People’s Hospital, Huai’an, 223002, Jiangsu Province, People’s Republic of China

    Xingxia Zhang

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  1. Limin Liu
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  9. Miao Miao
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  10. Depei Wu
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Corresponding authors

Correspondence to Miao Miao or Depei Wu.

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The First Affiliated Hospital of Soochow University and Huai'an Hospital Affiliated to Xuzhou Medical College Ethics Committee approved this study; patients were recruited after obtaining informed consent.

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Liu, L., Zhang, X., Qiu, H. et al. HLA-mismatched stem cell microtransplantation compared to matched-sibling donor transplantation for intermediate/high-risk acute myeloid leukemia. Ann Hematol 98, 1249–1257 (2019). https://doi.org/10.1007/s00277-018-3583-3

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