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

摘要

BackgroundThis study compared the effects of pre-transplantation minimal residual disease (pre-MRD) on outcomes in AML patients who underwent human leukocyte antigen-matched sibling donor transplantation (MSDT) or who received unmanipulated haploidentical allografts. MethodsA retrospective study ( n =?339) and a prospective study ( n =?340) were performed. MRD was determined using multiparameter flow cytometry. ResultsEither after retrospective or prospective analysis, patients with negative pre-MRD (pre-MRDneg) had a lower incidence of relapse than those with positive pre-MRD (pre-MRDpos) in MSDT settings ( P P =?0.866 and 0.161, respectively). In either the retrospective ( n =?65) or the prospective study ( n =?76), pre-MRDpos subjects receiving Haplo-SCT experienced a lower incidence of relapse than those who underwent MSDT ( P p =?0.017, respectively). Of the patients with pre-MRDpos in either the total ( n =?141) or the subgroup excluding cases which received donor lymphocyte infusion (DLI; n =?105), those who underwent MSDT had a higher incidence of relapse than those receiving haplo-SCT ( P ConclusionsThe results indicated that, for pre-MRD-positive AML patients, haplo-SCT was associated with lower incidence of relapse and better survival, suggesting a stronger anti-leukemia effect.