Unmanipulated haploidentical allogeneic stem cell transplantation (Allo-SCT) has become an attractive alternative for patients lacking HLA-matched sibling or unrelated donors. However, data of outcome in ALL is still scarce. The outcomes of 1234 adult patients with ALL in first complete remission (CR1) who underwent Allo-SCT between 2007 and 2016 were analyzed. Comparison was done between haploidentical donor (Haplo) (136 patients), matched unrelated donor (MUD 10/10) (809 patients), and mismatched unrelated donor (MMUD 9/10) (289 patients). Univariate analysis showed similar outcomes in Haplo, MUD, and MMUD, including OS, LFS, RI, NRM, AGVHD, and CGVHD. In multivariate analysis, Haplo was not associated with worse outcomes compared to MUD 10/10 and MMUD 9/10. Indeed, compared to Haplo, the hazard ratio (HR) for LFS, OS, RI, NRM, AGVHD, and CGVHD were 1.1 (p = 0.7), 0.9 (p = 0.4), 1.35 (p = 0.2), 0.7 (p = 0.2), 1.1 (p = 0.8), and 0.8 (p = 0.2) for MUD, respectively, and 1.1 (p = 0.8), 1.0 (p = 1.0), 1.2 (p = 0.3), 0.8 (p = 0.4), 1.2 (p = 0.3), and 0.9 (p = 0.6) for MMUD, respectively. In conclusion, outcomes of adult patients with ALL in CR1 receiving Haplo Allo-SCT are comparable to MUD or MMUD transplants. Haplo should be considered as a clinically relevant option for patients lacking a matched sibling donor.

1st State Pavlov Medical University of St Petersburg Raisa Gorbacheva Memorial Research Institute for Paediatric Oncology Hematology and Transplantation St Petersburg Russia

Acute Leukemia Working Party of the EBMT Paris France

Charles University Hospital Department of Hematology Oncology Pilsen Czech Republic

CHU Nantes Département D'Hematologie Nantes France

Department of Bone Marrow Transplantation and Oncohematology Maria Sklodowska Curie Memorial Cancer Center and Institute of Oncology Gliwice Branch Gliwice Poland

Department of Haematology EBMT Paris study Office CEREST TC and Université Pierre et Marie Curie Paris France

Department of Hematology EBMT Paris Study Office CEREST TC Saint Antoine Hospital Paris France

Division of Hematology and Bone Marrow Transplantation Chaim Sheba Medical Center Tel Aviv University Tel Aviv Israel

Hospices Civils de Lyon Centre Hospitalier Lyon Sud Lyon France

Hospital St Louis Department of Hematology BMT Paris France

HUCH Comprehensive Cancer Center Stem Cell Transplantation Unit Helsinki Finland

Karolinska University Hospital Department of Hematology Stockholm Sweden

Klinikum Grosshadern Med Klinik 3 Munich Germany

Programme de Transplantation and Therapie Cellulaire Centre de Recherche en Cancérologie de Marseille Institut Paoli Calmettes Marseille France

Saint Antoine Hospital Paris France

Silesian Medical Academy University Department of Haematology and BMT Katowice Poland

University Hospital Eppendorf Bone Marrow Transplantation Centre Hamburg Germany

University of Zagreb School of Medicine Department of Internal Medicine Zagreb Croatia

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