Haploidentical Hematopoietic Cell Transplantation Combined with Umbilical Cord Blood Versus Haploidentical Hematopoietic Cell Transplantation in T-Cell Acute Lymphoblastic Leukemia Patients: A Multicenter Real-World Study.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
Allogeneic hematopoietic cell transplantation (allo-HCT) is a promising treatment option for T-cell acute lymphoblastic leukemia (T-ALL). Co-infusion of umbilical cord blood (UCB) in haploidentical cell transplantation (haplo HCT) (haplo-cord HCT) for acute myeloid leukemia and B-cell acute lymphoblastic leukemia is a promising treatment in previous studies, but the clinical outcomes of T-ALL patients with haplo HCT whether combined with UCB remain unclear. Between 2012 and 2022, a total of 281 T-ALL patients including 190 with UCB (haplo-cord HCT group) and 91 without UCB (haplo HCT group) in 4 centers were retrospectively analyzed. No differences were observed in neutrophil or platelet reconstitution or transplantation-related complications including cumulative incidence of grade II-IV aGVHD. In the haplo-cord HCT group, there was a greater absolute count of CD3-CD16+CD56+ cells at +1 month (P = .003) and +3 months (P < .001) and a greater absolute count of CD3+ cells at +9 months (P = .025) and +1 year (P = .004); and the incidence of Epstein-Barr virus (EBV) viremia was lower in the haplo-cord HCT group (P < .002). Compared with the haplo HCT group, the haplo-cord HCT group exhibited better 2-year prognosis (OS: 72.7% versus 61.0%, P = .008; DFS: 67.0% versus 49.6%, P = .001; CIR: 23.9% versus 36.8%, P = .048) and similar NRM (12.0% versus 21.3%, P = .061). Subgroup analyses suggested that patients who were adolescents/young adults (P = .016), exhibited a non-early T-cell precursor (P = .001), required ≥2 courses of induction chemotherapy to achieve complete remission (CR) (P < .001) and were at CR1 status at transplantation (P = .005) could benefit from haplo-cord HCT for survival. Multivariate analyses revealed that haplo-cord HCT independently improved the OS (P = .004) and DFS (P < .001) of T-ALL patients. In conclusion, haplo-cord HCT may represent an optimal treatment strategy for T-ALL patients.