Haploidentical Versus Matched Donor Allo-HCT in Ph+ ALL

Haploidentical (HID)-allogeneic hematopoietic cell transplantation (allo-HCT) was just as effective as matched donor (MD)-HCT in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who received tyrosine kinase inhibitors (TKIs), according to a systematic review and meta-analysis. The results were presented during the 2021 ASCO Annual Meeting.

The Embase and Medline databases were queried from inception through December 2020 using search terms related to “Ph+ ALL” and “HCT” for relevant randomized, controlled trials or cohort studies on patients with Ph+ ALL who received a TKI and allo-HCT. The primary outcomes of interest were overall survival (OS) or relapse-free survival (RFS).

Final analysis comprised 13 cohort studies. RFS was superior among patients who received HID-HCT compared to MD-HCT (pooled odds ratio [OR], 1.64; 95% confidence interval [CI], 1.07-2.53; I2=0%). OS was similar between the groups (pooled OR, 1.11; 95% CI, 0.74-1.69; I2=0%). Patients who received HID-HCT had a lower relapse rate (pooled OR, 0.53; 95% CI, 0.33-0.86; I2=0%) but higher risks of graft-versus host disease (GVHD), including acute GVHD (pooled OR, 2.12; 95% CI, 1.05-4.31; I2=0%) and chronic GVHD (pooled OR, 1.63; 95% CI, 1.01-2.62; I2=0%). OS and RFS were comparable among matched sibling-HSCT, matched unrelated-HCT, and cord-blood HCT versus HID-HCT.

“This systematic review and meta-analysis showed that HID-HCT is as effective as MD-HCT and appears to be safe to implement in Ph+ ALL patients which could become useful in the case where there was no available donor,” the study authors concluded.