Haploidentical transplantation compared with matched sibling and unrelated donor transplantation for adults with standard‐risk acute lymphoblastic leukaemia in first complete remission

Summary We retrospectively investigated outcomes of haploidentical donor ( HID ) transplant for adults with standard‐risk acute lymphoblastic leukaemia ( ALL ) in first complete remission ( CR 1) compared with human leucocyte antigen ( HLA )‐matched sibling donor ( MSD ) and HLA ‐matched unrelated donor ( MUD ) transplants. A total of 348 adult patients were enrolled, including 127 HID , 144 MSD and 77 MUD recipients. The cumulative incidence of grade II – IV acute graft‐ versus ‐host disease ( aGVHD ) was 39·5%, 24·0% and 40·3% for HID , MSD and MUD , respectively ( P  =   0·020). However, there was no difference in grade III – IV aGVHD (11·4%, 7·7%, 13·5%, respectively, P  =   0·468). The 5‐year cumulative transplant‐related mortality was 16·4%, 11·6% and 19·6% ( P  =   0·162), the 5‐year relapse rate post‐transplantation was 14·8%, 21·1% and 16·7% ( P  =   0·231), the 5‐year overall survival was 70·1%, 73·7% and 69·8% ( P  =   0·525), and the 5‐year disease‐free survival was 68·7%, 67·3% and 63·7%, respectively ( P  =   0·606). Furthermore, the 3‐year GVHD ‐free, relapse‐free survival was not different (50·8%, 54·9% and 52·2%, respectively, P  =   0·847). Our results indicate that the outcomes of HID transplants are equivalent to those of MSD and MUD , and that HID transplantation is a valid alternative for standard‐risk adults with ALL in CR 1 who lack matched donors.