Comparative Study Of Related HLA-haploidentical Unmanipulated High Dose Peripheral Stem Cell Transplatation And HLA-matched Sibling Peripheral Blood Stem Cell Transplantation In The Treatment Of High-risk And Refractory/relapsed AML

Objective:The aim of this study was to investigate the comparative prognosis between Haplo-HDPSCT and MS-PSCT in the treatment of high-risk and refractory/relapsed AML.Methods:A total of 110 patients with high-risk or refractory/relapsed AMLwho underwent myeloablative conditioning regimenperipheral blood stem cell transplantation at our center between January 1^st2010 and June 30^th2020were retrospectively enrolled,including 69 patients in haploidentical group and 41patients in HLA-matched group.Results:Analyzing the median time to neutrophil recovery between haploidentical and HLA-matched groups,respectively,was 16 and15days（P=0.508）,to platelet recovery was 16 and 16 days（P=0.892）.To cumulative incidence ofgrade II-IV a GVHD was 27.75%and 17.06%,respectively（P=0.217）,and to 2-year cumulative incidence ofc GVHD was 49.28%and 53.66%,respectively（P=0.229）.In this trial,the 3-year OS was 67.76%（95%CI,56.20-79.32）in haploidentical group and 53.29%（95%CI,37.02-69.56;P=0.359）in HLA-matched group,the 3-year DFS was 63.73%（95%CI,51.97-75.49）and 49.05%（95%CI,32.98-65.12）in haploidentical and HLA-matched groups,respectively（P=0.390）,with no statistical difference between the two groups.The 3-year cumulative incidence of relapse was20.95%in haploidentical group and 42.25%in HLA-matched group,It was higher in HLA-matched group compared with haploidentical group（P=0.012）.There were no statistically significant differences between the two groups in terms of stem cell engraftment,incidence of grade II-IV a GVHD,incidence of c GVHD,post transplant complications,OS and DFS,but the haploidentical group had a lower risk of relapse after transplantation than the HLA-matchedgroup.Conclusion:Haplo-HDPSCT for high-risk and refractory/relapsed AML showed a lower relapse rate than MS-HSCT.