Advances in haplo-identical stem cell transplantation in adults with high-risk hematological malignancies

Table 1 Summary of clinical approaches to haplo-identical bone marrow transplant

Ref.	n	Preparative regimen	T-cell depletion/engraftment	GVHD prophylaxis	Acute GVHD	Chronic GVHD	TRM	OS
Perugia,	255	TBI +/-	Yes	none	17%	< 5%	41%	47%2
Aversa et al[59-61]		MA	84%-96%
		ATG
Peking, GIAC[69,70]	250	MA	No	CsA, MTX	45%	31%	12%-48%	56%-71% AML1
		ATG	G-BM + G-PB	MMF				25%-60% ALL1
			100%
Montreal		TBI +/-	Yes	none	20%	25%	15%	47%
Bastien et al[56]	19	MA	T cell
		ATG	“Add Back”
			100%
Baltimore	210	NMA	No	Tacro, MMF	27%	13%	15%	40%-45%
Studies[64-67]			87%	PTCyclo
Di Bartolomeo et al[68]	88	MA 80%	No	CsA, MTX	24%	6%	36%	33%-54%1
		NMA 20%	G-BM	MMF
		ATG	91%	Basilixumab

¹Survival range including standard and high-risk groups;

²Survival for patients in complete remission. A variety of approaches have been studied that compare MA-myeloablative to NMA-non myeloablative, T cell depletion of graft, and GVHD prophylaxis. Engraftment rates are high, and GVHD can be attenuated through T cell depletion of the graft or by intensive anti-GVHD prophylaxis, including ATG. GVHD: Graft-vs-host disease; TRM: Treatment related mortality; OS: Overall survival; TBI: Total body irradiation; ATG: Anti-thymocyte globulin; CsA: Cyclosporine A; MTX: Methotrexate; MMF: Mycophenolate mofetil; PTCyclo: Post transplant cyclophosphamide; AML: Acute myeloid leukemia; ALL: Acute lymphoblastic leukemia; Tacro: Tacrolimus.