Are haploidentical stem cell transplants ideal for older patients with acute myeloid leukemia and myelodysplastic syndrome?

This study aimed to investigate whether haploidentical stem cell transplantation was safe and effective for older patients with acute myeloid leukemia and myelodysplastic syndrome.

This study concluded that haploidentical stem cell transplantation is safe and effective for older patients.

Acute myeloid leukemia (AML) occurs when abnormal myeloblasts are produced. These are a type of white blood cell that produce other cells. This leads to no healthy cells being produced which results in a weak immune system, infection and bleeding.

Myelodysplastic syndrome (MDS) includes groups of cancers in which immature blood cells do not become mature or healthy blood cells.

Both AML and MDS are common in older patients. An allogeneic stem cell transplantation (SCT) is often used as treatment. Stem cells are taken from a matching donor and transferred to a patient. These cells can then help the patient replenish cells they have lost.

Haploidentical stem cell transplantation is when the cells have a 50% match with the patient. The cells usually come from a parent, sibling or child. It is not known if haploSCT is a good option for older patients with AML.

This study involved 43 patients who had AML and MDS and who underwent haploSCT. Patients underwent a fludarabine–melphalan-based reduced-intensity conditioning regimen. This is a chemotherapy treatment. Patients received post-transplant cyclophosphamide-based treatment to prevent graft-versus-host disease (GVHD). GVHD is a condition where the body attacks its own cells. Patients were followed for an average of 19 months.

98% of patients engrafted donor cells. This refers to the donor cells beginning to make blood cells.

The incidence of grade II to IV acute GVHD at 6 months was 35%. The incidence of grade III to IV acute GVHD at 6 months was 5%. The incidence of chronic GVHD at 2 years was 9%.

The 2-year rate of overall survival (time from treatment until death from any cause) was 42%. Two-year progression-free survival (PFS; time from treatment until disease progression) was also 42%. The incidence of relapse (disease returns) at 2 years was 24%. 

Patients who had low- to intermediate-risk disease and those in their first or second remission (period with no evidence of disease) were more likely to have a better PFS.

This study concluded that haploSCT is safe and effective for older patients with AML and MDS.

Consult your physician about haploSCT as a treatment option.