Haploidentical Donor vs mMUD in Hematological Malignancies

Inclusion Criteria

• •1. Eligible diagnoses are listed below:
• •AML with adverse risk genetic abnormalities (according to the ELN guidelines)1. AML with intermediate genetic abnormalities (according to ELN guidelines) either in first complete remission, after relapse, or by chemotherapy-refractory disease.
• •AML with favourable genetic abnormalities (according to ELN guidelines) after relapse or by chemotherapy-refractory disease, except APL.
• •AML with undefined genetic risk classification after relapse or with chemotherapy-refractory disease.
• •AML arising from myelodysplastic syndrome (MDS) or a myeloproliferative neoplasia, except if favourable genetic abnormalities (according to ELN guidelines) are present.
• •Therapy-related myeloid neoplasia except if favorable genetic abnormalities (according to ELN guidelines) are present.
• •MDS with high risk or very high risk disease (according to the IPSS-R score)2.
• •First CR of high-risk ALL, defined by one or more of these:
• •* Early or mature T-ALL (CD1a negative).
• •* Pro B-ALL with t(4v;11); KMT2A-rearrangements.
• •* Presence of BCR-ABL and/or t(9;22).
• •* Persistence of minimal residual disease after the second induction course. ALL with or without complete remission after salvage therapy following poor response to induction therapy.
• •ALL after haematological or molecular relapse.
• •2. Fit for transplant according to physician judgement.
• •3. No history of cardiac disease and absence of active symptoms, otherwise, documented left ventricular ejection fraction ≥40%.
• •4. No history of chronic pulmonary disease and absence of dyspnea. Otherwise, documented diffusion lung capacity for carbon monoxide (DLCO) ≥40% or FEV1/FVC ≥ 50% despite appropriate treatment
• •5. Availability of ≥1 unrelated donor with a single allele or antigen mismatch at HLA-A, -B, -C, or -DRB1 and no concurrent DQB1 mismatch (9/10) shown by confirmatory typing.
• •6. Availability of at least one haploidentical donor meeting the following criteria:
• •Donor is a biologic parent / child of the patient, or haploidentity has been confirmed for patient's relatives by HLA-Typing.
• •The donor has expressed his/her will to donate and has no contraindications against a stem cell donation by medical history.
• •Donor age is ≥18 years and ≤75 years.