This study aimed to investigate graft-versus-leukemia (GVL) of haploidentical donor (HID) compared with HLA-matched sibling donor (MSD) for high-risk acute myeloid leukemia (H-AML) in first complete remission (CR1). One hundred and eighty-nine patients with H-AML in CR1 were enrolled in this multicentre prospective cohort study. Patients were assigned to groups transplanted with HID (n = 83) or MSD (n = 106) based on donor availability (biological randomization). The primary endpoint was the incidence of MRD positivity posttransplantation (post-MRD+). All post-MRD+ patients received preemptive interventions. The cumulative incidences of post-MRD+ were 18 and 42% in HID and MSD groups, respectively, (p < 0.001). Fifty-two patients received preemptive DLI, including 13 (16%) in HID and 39 cases (37%) in MSD groups (p = 0.001). Among HID and MSD groups, the 3-year cumulative incidence of relapse were 14 and 24% (p = 0.101); the 3-year cumulative incidence of treatment-related mortality were 15 and 10% (p = 0.368); the 3-year overall survival rates were 72 and 68% (p = 0.687); the 3-year disease-free-survival were 71 and 66% (p = 0.579); the 3-year graft-versus-host disease and relapse free survival were 63 and 43% (p = 0.035), respectively. HID might have a stronger GVL than MSD in H-AML patients. HID transplantation as postremission therapy should be recommended as one of the optimal choices for H-AML patients in CR1.

中文翻译：

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在首次完全缓解的情况下，对于高危急性髓性白血病，单倍体移植可能比HLA匹配兄弟姐妹移植具有更好的移植物抗白血病作用：一项前瞻性多中心队列研究。

这项研究旨在调查单次捐献者（HID）的移植物抗白血病（GVL）与HLA匹配同胞捐献者（MSD）在首次完全缓解（CR1）中的高危急性髓系白血病（H-AML）的比较。这项多中心前瞻性队列研究纳入了189名CR1中的H-AML患者。根据供体可用性（生物随机化）将患者分为接受HID（n = 83）或MSD（n = 106）移植的组。主要终点是移植后MRD阳性的发生率（MRD +后）。所有MRD +后患者均接受了先发性干预。在HID和MSD组中，MRD +之后的累积发生率分别为18％和42％（p <0.001）。52例患者接受了抢先DLI，其中HID患者13例（16％），MSD组39例（37％）（p = 0.001）。在HID和MSD组中，三年累计复发率分别为14％和24％（p = 0.101）；与治疗相关的死亡率的3年累积发生率分别为15％和10％（p = 0.368）；3年总生存率分别为72％和68％（p = 0.687）；3年无病生存率分别为71％和66％（p = 0.579）；3年移植物抗宿主病和无复发生存率分别为63％和43％（p = 0.035）。在H-AML患者中，HID的GVL可能强于MSD。对于CR1的H-AML患者，应建议将HID移植作为缓解后的治疗方法，作为其最佳选择之一。3年无病生存率分别为71％和66％（p = 0.579）；3年移植物抗宿主病和无复发生存率分别为63％和43％（p = 0.035）。在H-AML患者中，HID的GVL可能强于MSD。对于CR1的H-AML患者，应建议将HID移植作为缓解后的治疗方法，作为其最佳选择之一。3年无病生存率分别为71％和66％（p = 0.579）；3年移植物抗宿主病和无复发生存率分别为63％和43％（p = 0.035）。在H-AML患者中，HID的GVL可能强于MSD。对于CR1的H-AML患者，应建议将HID移植作为缓解后的治疗方法，作为其最佳选择之一。