Clinical Report: Broadening the Donor Options for Secondary Acute Myeloid Leukemia

Background

Secondary acute myeloid leukemia (sAML) presents unique challenges due to its aggressive nature and limited treatment options. The traditional donor hierarchy for allo-HCT prioritizes HLA-matched donors, but the introduction of PTCy has expanded the potential donor pool. Understanding the efficacy of haploidentical versus MMUD transplants is crucial for optimizing treatment strategies in this patient population.

Data Highlights

No specific numerical data provided in the source material.

Key Findings

• Haploidentical and MMUD transplants show comparable overall survival rates when using PTCy.
• PTCy-based prophylaxis correlates with reduced rates of severe acute GVHD compared to ATG-based approaches.
• Donor age impacts outcomes, with younger haploidentical donors associated with better survival rates.
• Registry data limitations include the exclusion of TP53 mutations and measurable residual disease status.
• Delayed immune reconstitution in haploidentical transplant recipients may lead to increased infection-related complications.

Clinical Implications

The findings support the use of haploidentical donors as a viable option for sAML patients when HLA-matched donors are unavailable. Clinicians should consider donor age and the potential for delayed immune reconstitution when planning transplantation strategies.

Conclusion

The study highlights the potential for haploidentical donors to provide outcomes similar to MMUDs in sAML, emphasizing the need for timely transplantation in this aggressive disease context.

Related Resources & Content

1. Kayser et al., Bone Marrow Transplantation, 2026 -- T-cell replete haploidentical transplantation compared to mismatched unrelated allogeneic transplantation with post-transplantation cyclophosphamide in patients with secondary acute myeloid leukemia in first complete remission
2. Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations, Bone Marrow Transplantation, 2025
3. Bone Marrow Transplantation — The Impact of Donor Age on Transplant Outcomes in Acute Myeloid Leukemia
4. Bone Marrow Transplantation — 49th Annual Conference of the European Society for Blood and Marrow Transplantation: Physician Poster Presentations (P001-P708)
5. Bone Marrow Transplantation — The 50th Annual Conference of the European Society for Blood and Marrow Transplantation: Physician Presentations (O009-O154)
6. Bone Marrow Transplantation — The 47th Annual Conference of the European Society for Blood and Marrow Transplantation: Physician Presentations (O010 – O169)
7. Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations | Bone Marrow Transplantation
8. T-cell replete haploidentical transplantation compared to mismatched unrelated allogeneic transplantation with post-transplantation cyclophosphamide in patients with secondary acute myeloid leukemia in first complete remission: A study from the ALWP/EBMT | Bone Marrow Transplantation
9. Peripheral blood stem cells versus bone marrow graft for non-T-depleted haploidentical transplantation with post-transplant cyclophosphamide in patients with secondary acute myeloid leukemia in first complete remission: A study from the ALWP/EBMT | Bone Marrow Transplantation