Among patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or acute lymphoid leukemia (ALL), haploidentical peripheral blood stem cell transplantation supported by third-party cord blood (haplo-cord-PBSCT) yields similar outcomes to human leukocyte antigen-matched sibling donor (MSD)-PBSCT, according to research published in Frontiers in Oncology.
The introduction of haploidentical hematopoietic stem cell transplantation (SCT) helped to provide care for patients where there was a shortage of donors. Data suggest that this process has become more common over the last several years, providing much-needed treatment to patients with hematologic cancers including AML, MDS, and ALL.
Although many studies have evaluated the safety and efficacy of SCT using bone marrow plus PB, few have reviewed outcomes with haplo-cord-PBSCT. For this retrospective study, researchers compared the safety and efficacy of MSD-PBSCT with haplo-cord-PBSCT among patients with AML, MDS, or ALL.
Overall, data from 165 patients with hematologic cancers were included in this study; among these, 93 received haplo-cord-PBSCT and 72 received MSD-PBSCT. In the haplo-cord-PBSCT and MSD-PBSCT groups, 52.7% and 47.2% of patients were male sex, respectively, 57% and 66.7% of patients had AML or MDS, and the median ages were 32 and 36 years. Notably, patients in the haplo-cord-PBSCT group were more likely to have high-risk disease features (P =.02).
Results showed that the median times for both neutrophil and platelet engraftment were not significantly different between the 2 groups (P =.07 and P =.06, respectively). Similarly, the 30-day cumulative incidences of neutrophil engraftment were 100.0% in the haplo-cord-PBSCT group and 98.6% in the MSD-PBSCT group (P =.12).
The 100-day cumulative incidences of platelet engraftment were, however, higher in the MSD-PBSCT group (98.6% vs 96.8% in the haplo-cord-PBSCT group; P =.01).
Graft vs host disease rates at 100 days and at 1 year, the 1-year cumulative relapse rates, and the 1-year non-relapse mortality rates did not significantly differ between the 2 arms.
Differences in overall survival and disease-free survival rates, similarly, were above the statistical threshold of significance.
“In summary, the findings of this study indicate that haploidentical PBSCT supported by third-party cord blood results in [overall survival] and cumulative incidences of [graft-vs-host disease], [non-relapse mortality], and relapse, similar to those of MSD PBSCT, although the patients with high-risk features in the haplo-cord-PBSCT group were more than those in the MSD-PBSCT group,” the authors wrote in their report.
Cheng T, Chen Y, Liu Y, et al. Comparison of outcomes of haploidentical peripheral blood stem cell transplantation supported by third-party cord blood versus human leukocyte antigen-matched sibling peripheral blood stem cell transplantation in hematologic malignancy patients. Front Oncol. 2022;12:922120. doi: 10.3389/fonc.2022.922120