We compared the outcomes of haploidentical stem cell transplantation (haplo-HSCT) with posttransplant cyclophosphamide (PTCy) in 719 patients with primary refractory (PR) or first relapse (Rel) secondary acute myeloid leukemia (sAML; n = 129) vs those with de novo AML (n = 590), who received HSCT between 2010 and 2022. A higher percentage of patients with sAML vs de novo AML had PR disease (73.6% vs 58.6%; P = .002). In 81.4% of patients with sAML , the antecedent hematological disorder was myelodysplastic syndrome. Engraftment was 83.5% vs 88.4% in sAML and de novo AML, respectively (P = .13). In multivariate analysis, haplo-HSCT outcomes did not differ significantly between the groups: nonrelapse mortality hazard ratio (HR), 1.38 (95% confidence interval [CI], 0.96-1.98; P = .083), relapse incidence HR, 0.68 (95% CI, 0.4.7.-1.00; P = .051). The HRs for leukemia-free survival, overall survival, and graft-versus-host disease (GVHD)-free, and GVHD and relapse-free survival were 0.99 (95% CI, 0.76-1.28; P = .94), 0.99 (95% CI, 0.77-1.29; P = .97), and 0.99 (95% CI, 0.77-1.27; P = .94), respectively. We conclude that outcomes of haplo-HSCT with PTCy are not different for PR/Rel sAML in comparison with PR/Rel de novo AML, a finding of major clinical importance.

Azienda Ospedaliero Universitaria di Udine Udine Italy

CHU Bordeaux Hopital Haut Leveque Pessac France

Department of Haematology EBMT Paris Study Office Saint Antoine Hospital INSERM UMR 938 Sorbonne University Paris France

Department of Hematology Sorbonne University Saint Antoine Hospital INSERM UMR 938 Paris France

Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico A Gemelli IRCCS Sezione di Ematologia Dipartimento di Scienze Radiologiche ed Ematologiche Università Cattolica del Sacro Cuore Rome Italy

Division of Haematology Sheba Medical Center Tel Hashomer Israel

Institute of Hematology and Blood Transfusion Prague Czech Republic

IRCCS Ospedale Policlinico San Martino Genoa Italy

Klinikum Grosshadern Munich Germany

Ospedale San Raffaele Haematology and Bone Marrow Transplantation Milan Italy

Programme de Transplantation and Therapie Cellulaire Marseille France

University Hospital Erlangen Erlangen Germany

University Hospital Maastricht Maastricht The Netherlands

University Hospital TU Dresden Dresden Germany

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Blood Adv. 2024 Aug 13;8(15):4221-4222. doi: 10.1182/bloodadvances.2024013318. PubMed

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