Type of Donor in the Setting of Allogeneic Stem Cell Transplant Does Not Significantly Affect Overall Survival in Patients with Acute Myeloid Leukemia

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<h3>Background</h3> Acute myeloid leukemia (AML) remains a disease of high mortality and allogeneic hematopoietic stem cell transplant (HCT) is frequently indicated for its curative potential. However, access can be limited by availability of HLA-matched donors, comorbidities, and performance status. Recently, half-match (haploidentical) donors and reduced-intensity conditioning (RIC) have increasingly been used to alleviate limitations. The objective of this study is to compare outcomes between different types of donors (matched-sibling (MSD) vs matched-unrelated (MUD) vs haploidentical (HI) and to investigate the role of conditioning for patients with AML. <h3>Methods</h3> In this single-center retrospective study, 253 AML patients receiving first allo-HCT between 2013-2018 were included. Baseline characteristics were collected and the primary outcome of overall survival was evaluated with Kaplan Meier survival analysis and hazard ratios using cox regression models. Baseline difference between these groups were significant for mean age of donor [53.0 years (MSD), 34.8 (HI), 27.8 (MUD); p<0.01], conditioning type [53% myeloablative (MSD), 13% (HI), 45% (MUD); p<0.01], and gender of donor [84% male (MUD), 64% (HI), 57% (MSD); p<0.01]. <h3>Results</h3> Two-year survival amongst groups stratified by type of donor was not significantly different with 44.0% for MSD (95% CI: 30.4 to 57.6), 53.8% for MUD (95% CI: 44.4 to 63.2), and 53.5% for HI (95% CI: 38.6 to 70.0). When patients were stratified by conditioning type, differences in overall survival were also not statistically significant. <h3>Conclusion</h3> In this cohort of adult patients with AML, receiving an allo-HCT. Overall survival outcomes were not different between different donor types. This data is consistent with other recent reports demonstrating similar outcomes with haploidentical transplants when compared to matched-donor transplant.