Comparative outcomes of various donor sources for HCT in AML
| Study . | Sample size and patient population . | Disease status . | Main comparison . | LFS and OS . | Additional comments . |
|---|---|---|---|---|---|
| Hegenbert et al, 2006,57 Multicenter, Seattle Consortium | 122, age 17-74 y, using NMA conditioning only | CR1 (n = 51), CR2 (n = 39), advanced (n = 32) | MRD (n = 58) vs MUD (n = 64) | No difference between MRD and MUD | Disease status at HCT and cytogenetics most important factors for LFS and OS |
| Moore et al, 2007,58 Multicenter, Australasian Registry | 210, age 16-59 y, using MAC only | CR1 (n = 36), > CR1/others (n = 174) | MSD (n = 105) vs URD (n = 105) | No difference between MSD and URD | Matched case-controlled study |
| Schetelig et al, 2008,59 Multicenter, Germany | 368, age 50-73 y, both MAC and RIC | CR1 (n = 136), advanced, (n = 228), others (n = 4) | MSD (n = 168) vs M/MRD (n = 12) vs MUD (n = 51) vs possibly MUD (n = 68) vs partially MUD (n = 45) vs poorly MUD (n = 24) | No difference between different donor types | Advanced disease at HCT, secondary AML, and high risk cytogenetics associated with poor outcomes |
| Atsuta et al, 2009,54 Multicenter, JMDP/JCBBN | 484, age 16-69 y, using MAC only | CR1 (n = 180), Others (n = 304) | MUD (n = 311) vs UCB-HCT (n = 173) | Inferior outcomes in UCB-HCT attributable to increased TRM | No difference in risk of relapse |
| Walter et al, 2010,49 single center, Seattle | 220, age 18-69 y, using MAC only | CR1, Intermediate cytogenetics (n = 141), high risk cytogenetics (n = 60), others (n = 19) | MRD (n = 135) vs 10/10 MUD (n = 62) vs 9/10 URD (n = 23) | No difference between MRD vs 10/10 MUD vs 9/10 URD | Unfavorable cytogenetics and high HCT-CI score associated with worse outcomes |
| Gupta et al, 2010,48 Multicenter, CIBMTR | 584, age <1-74 y, Both MAC and RIC | AML in CR1 with adverse cytogenetics | MSD (n = 226) vs well-matched URD (n = 254) vs Partially matched URD (n = 104) | Similar between MSD and well-matched URD, inferior for partially matched URD | Lower risk of relapse in patients with chronic GVHD |
| Schlenk et al, 2010,46 Multicenter, Germany and Austria | 162, age 19-61 y, Both MAC and RIC | High-risk AML in CR1, patients refractory to induction therapy | MRD (n = 62) vs MUD (n = 89) vs CB/HaploHCT (n = 11) | Similar between MSD and MUD | Prospective study, also compared with patients who could not get transplant, benefit of HCT seen in comparison with non-HCT patients in landmark analysis |
| Study . | Sample size and patient population . | Disease status . | Main comparison . | LFS and OS . | Additional comments . |
|---|---|---|---|---|---|
| Hegenbert et al, 2006,57 Multicenter, Seattle Consortium | 122, age 17-74 y, using NMA conditioning only | CR1 (n = 51), CR2 (n = 39), advanced (n = 32) | MRD (n = 58) vs MUD (n = 64) | No difference between MRD and MUD | Disease status at HCT and cytogenetics most important factors for LFS and OS |
| Moore et al, 2007,58 Multicenter, Australasian Registry | 210, age 16-59 y, using MAC only | CR1 (n = 36), > CR1/others (n = 174) | MSD (n = 105) vs URD (n = 105) | No difference between MSD and URD | Matched case-controlled study |
| Schetelig et al, 2008,59 Multicenter, Germany | 368, age 50-73 y, both MAC and RIC | CR1 (n = 136), advanced, (n = 228), others (n = 4) | MSD (n = 168) vs M/MRD (n = 12) vs MUD (n = 51) vs possibly MUD (n = 68) vs partially MUD (n = 45) vs poorly MUD (n = 24) | No difference between different donor types | Advanced disease at HCT, secondary AML, and high risk cytogenetics associated with poor outcomes |
| Atsuta et al, 2009,54 Multicenter, JMDP/JCBBN | 484, age 16-69 y, using MAC only | CR1 (n = 180), Others (n = 304) | MUD (n = 311) vs UCB-HCT (n = 173) | Inferior outcomes in UCB-HCT attributable to increased TRM | No difference in risk of relapse |
| Walter et al, 2010,49 single center, Seattle | 220, age 18-69 y, using MAC only | CR1, Intermediate cytogenetics (n = 141), high risk cytogenetics (n = 60), others (n = 19) | MRD (n = 135) vs 10/10 MUD (n = 62) vs 9/10 URD (n = 23) | No difference between MRD vs 10/10 MUD vs 9/10 URD | Unfavorable cytogenetics and high HCT-CI score associated with worse outcomes |
| Gupta et al, 2010,48 Multicenter, CIBMTR | 584, age <1-74 y, Both MAC and RIC | AML in CR1 with adverse cytogenetics | MSD (n = 226) vs well-matched URD (n = 254) vs Partially matched URD (n = 104) | Similar between MSD and well-matched URD, inferior for partially matched URD | Lower risk of relapse in patients with chronic GVHD |
| Schlenk et al, 2010,46 Multicenter, Germany and Austria | 162, age 19-61 y, Both MAC and RIC | High-risk AML in CR1, patients refractory to induction therapy | MRD (n = 62) vs MUD (n = 89) vs CB/HaploHCT (n = 11) | Similar between MSD and MUD | Prospective study, also compared with patients who could not get transplant, benefit of HCT seen in comparison with non-HCT patients in landmark analysis |
CIBMTR indicates Center for International Blood and Marrow Transplant Research; CR1, first complete remission; CR2, second complete remission; GVHD, graft versus host disease; haploHCT, haplo-identical cell transplantation; HCT, hematopoietic cell transplantation; HCT-CI, hematopoietic cell transplantation comorbidity index; JCCBN, Japanese cord blood bank network; JMDP, Japanese Marrow Donor Program; LFS, leukemia-free survival; MAC, myeloablative conditioning; NMA, nonmyeloablative; OS, overall survival; M/MRD, mismatched related donor; MRD, matched related donor; MSD, matched sibling donor; MUD, matched unrelated donor; RIC, reduced-intensity conditioning; TRM, treatment-related mortality; UCB, umbilical cord blood; and URD, unrelated donor.