Compared with HLA-matched sibling donor (MSD) transplant, the outcomes of haploidentical donor (HID) transplant for refractory acute leukemia need to be further explored. In this study, we compared the outcomes of HID with MSD for refractory acute leukemia. This study population came from two prospective multicenter trials (NCT01883180, NCT02673008). Two hundred and seventy-eight patients with refractory acute leukemia were enrolled in this study, including 119 in HID group and 132 in MSD group. Sequential intensified conditioning was employed in all patients, and donor lymphocyte infusion (DLI) was administered in patients in the absence of active GVHD and according to minimal residual disease (MRD) from day + 60 post-transplantation for preventing relapse. The complete remission of leukemia by day + 30 post-transplant were 94% and 93%, respectively, in HID and MSD groups (p = .802). The 1-year incidence of grades II–IV acute GVHD was 62% and 54% (p = .025), and 3-year incidence of chronic GVHD was 55% and 55% (p = .789), respectively, in two groups. HID transplant had lower incidence of first episode of MRD positivity and relapse than MSD transplant (28% vs 45%, p = .006; 26% vs 38%, p = .034). There was higher infection-related mortality in HID than MSD (8% vs 2%, p = .049) within the first 100 days’ post-transplant. The 5-year overall survival was 46% and 42% (p = .832), respectively; the 5-year disease-free survival was 43% and 39% (p = .665), in HID and MSD groups, respectively. HID transplant has lower relapse, but higher infection-related mortality and similar survival rates in refractory acute leukemia by the strategy of sequential intensified conditioning followed by DLI compared with MSD transplant.

中文翻译：

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难治性急性白血病的先天性与HLA匹配同胞移植，先后接受顺序强化治疗和DLI：来自两个前瞻性数据的分析。

与HLA匹配的同胞供体（MSD）移植相比，单倍体供体（HID）移植治疗难治性急性白血病的结果有待进一步探讨。在这项研究中，我们比较了HID和MSD治疗难治性急性白血病的结果。该研究人群来自两项前瞻性多中心试验（NCT01883180，NCT02673008）。本研究共纳入278例难治性急性白血病患者，其中HID组119例，MSD组132例。所有患者均采用顺序强化治疗，在无活动性GVHD的情况下，并根据移植后+60天的最小残留疾病（MRD），对患者进行供体淋巴细胞输注（DLI），以防止复发。移植后+ 30天白血病的完全缓解率分别为94％和93％，分别在HID和MSD组中（p = .802）。II–IV级急性GVHD的1年发生率分别为62％和54％（p = .025），而慢性GVHD的3年发生率分别为25％和55％（p = .789）。组。与MSD移植相比，HID移植的MRD阳性和复发的首发发生率较低（28％vs 45％，p = .006； 26％vs 38％，p = .034）。在移植后的前100天内，HID的感染相关死亡率高于MSD（8％对2％，p = .049）。5年总生存率分别为46％和42％（p = .832）；HID和MSD组的5年无病生存率分别为43％和39％（p = .665）。HID移植的复发率较低，