{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T22:52:13Z","timestamp":1789253533187,"version":"build-2803163510"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"\n Background<\/jats:title>\n Hematopoietic cell transplantation (HCT) increases survival for acute leukemia. Outpatient allogeneic HCT reduces costs and increases transplant rates in developing countries. We report outcomes of outpatient HLA-identical and haploidentical HCT in acute leukemia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single-center retrospective cohort study analyzed 121 adult patients with acute myeloblastic (AML) and acute lymphoblastic leukemia (ALL) receiving an outpatient allogeneic HCT with peripheral blood allografts after reduced-intensity conditioning (RIC) from 2012-2022.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were 81 (67%) haploidentical and 40 (33%) HLA-identical transplants. Complete chimerism (CC) at day +100 was not different in HLA-identical compared to haploidentical HCT (32.5% and 38.2%,\n P<\/jats:italic>\n =0.054). Post-HCT complications, including neutropenic fever (59.3% vs. 40%), acute graft-versus-host-disease (aGVHD) (46.9% vs. 25%), cytokine release syndrome (CRS) (18.5% vs. 2.5%), and hospitalization (71.6% vs 42.5%) were significantly more frequent in haploidentical HCT. Two-year overall survival (OS) was 60.6% vs. 46.9%, (\n P<\/jats:italic>\n =0.464) for HLA-identical and haplo-HCT, respectively. There was no difference in the 2-year disease-free-survival (DFS) (33.3% vs. 35%,\n P<\/jats:italic>\n =0.924) between transplant types. In multivariate analysis, positive measurable residual disease (MRD) at 30 days (HR 8.8,\n P<\/jats:italic>\n =0.018) and 100 days (HR 28.5,\n P<\/jats:italic>\n =0.022) was associated with lower OS, but not with non-relapse mortality (NRM) (\n P<\/jats:italic>\n =0.252 and\n P<\/jats:italic>\n =0.123, univariate). In univariate analysis, both 30-day and 100-day MRD were associated with lower DFS rates (\n P<\/jats:italic>\n =0.026 and\n P<\/jats:italic>\n =0.006), but only day 30 MRD was significant in multivariate analysis (\n P<\/jats:italic>\n =0.050). In the case of relapse, only MRD at day 100 was associated with increased risk in the univariate and multivariate analyses (HR 4.48,\n P<\/jats:italic>\n =0.003 and HR 4.67,\n P<\/jats:italic>\n =0.008). Chronic graft-versus-host-disease (cGVHD) was protective for NRM (HR 0.38,\n P<\/jats:italic>\n =0.015). There was no difference in cumulative incidence of relapse (CIR) between transplant types (\n P<\/jats:italic>\n =0.126). Forty-four (36.4%) patients died, with no difference between HCT type (\n P<\/jats:italic>\n =0.307). Septic shock was the most frequent cause of death with 17 cases, with no difference between transplant types\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Outpatient peripheral blood allogenic HCT after RIC is a valid and effective alternative for adult patients suffering acute myeloblastic or lymphoblastic leukemia in low-income populations.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fimmu.2024.1400610","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:24:47Z","timestamp":1728001487000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["A comparison of haploidentical versus HLA-identical sibling outpatient hematopoietic cell transplantation using reduced intensity conditioning in patients with acute leukemia"],"prefix":"10.3389","volume":"15","author":[{"given":"Jos\u00e9 Carlos","family":"Jaime-P\u00e9rez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Valdespino-Valdes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"G\u00f3mez-De Le\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Valeria","family":"Barrag\u00e1n-Longoria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Dominguez-Villanueva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga Graciela","family":"Cant\u00fa-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar Homero","family":"Guti\u00e9rrez-Aguirre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"G\u00f3mez-Almaguer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000485","article-title":"Allogeneic stem cell transplantation from unrelated donors in acute leukaemia","volume":"30","author":"Lozano Cerrada","year":"2018","journal-title":"Curr Opin Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2022.01.020","article-title":"Post-transplantation cyclophosphamide after HLA identical compared to haploidentical donor transplant in acute myeloid leukemia: A study on behalf of GETH-TC","volume":"28","author":"Bail\u00e9n","year":"2022","journal-title":"Transplant Cell 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