MATCHED-PAIR ANALYSIS OF TRANSPLANT FROM HAPLOIDENTICAL, UNMANIPULATED BONE MARROW DONOR VERSUS HLA IDENTICAL SIBLING FOR PATIENTS WITH HEMATOLOGICAL MALIGNANCIES

A matched-pair analysis of transplant-related outcomes was carried out in 116 of 255 consecutive patients transplanted from HLA identical sibling (n=58) or haploidentical related donor (n=58). The two patient series were matched with 9 variables: period of transplant, patient and donor age, gender, diagnosis, disease phase, conditioning regimen, donor/recipient sex and CMV status combinations. As graft-versus-host disease prophylaxis, all patients received the standard cyclosporine and methotrexate association with the addition of anti-thymocyte globulins, mycophenolate-mofetil and Basiliximab in haploidentical, unmanipulated bone marrow recipients. Anti-infectious management, transfusion policy and supportive care were identical for all patients. By comparing the two patient series, no statistically significant difference was observed for the cumulative incidence of advanced acute and extensive chronic GVHD, TRM and relapse. With a median follow-up of 3.5 years, the 5-year DFS was 37±6% and 36±6% for HLA Id-sib and haplo recipients, respectively. The results of transplant from HLA id-siblings and haploidentical donors are comparable. Regardless of the HLA matching, other factors known to affect the transplant outcomes such as donor-recipient age, sex and CMV status combinations might drive the search for the best donor.