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HLA-haploidentical vs matched-sibling hematopoietic cell transplantation: a systematic review and meta-analysis

Mohamad A. Meybodi, Wenhao Cao, Leo Luznik, Asad Bashey, Xu Zhang, Rizwan Romee, Wael Saber, Mehdi Hamadani, Daniel J. Weisdorf, Haitao Chu and Armin Rashidi

Abstract

HLA haploidentical hematopoietic cell transplantation (haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) is an alternative strategy when a matched sibling donor (MSD) is not available. We performed a systematic review and meta-analysis to compare the outcomes of MSD vs haplo-HCT. Eleven studies (1410 haplo-HCT and 6396 MSD recipients) were meta-analyzed. All studies were retrospective and high quality, and 9 were multicenter. Haplo-HCT was associated with ~50% lower risk of chronic graft-versus-host disease (GVHD) (hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.41-0.74), but higher risk of nonrelapse mortality (HR, 1.36; 95% CI, 1.12-1.66). Relapse, survival, acute GVHD, and GVHD-free relapse-free survival were not significantly different between the groups. Deciphering the relative contribution of PT-Cy and HLA disparity to the observed outcome differences between the groups requires further research.

  • Submitted June 24, 2019.
  • Accepted July 9, 2019.
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