Myeloablative haploidentical hematopoietic stem cell transplantation using basiliximab for graft-versus-host disease prophylaxis

Objectives: We retrospectively compared the prophylactic effect of basiliximab and antithymocyte globulin (ATG) after haploidentical hematopoietic stem cell transplantation (HSCT) in patients with leukemia. Methods: Haploidentical HSCT using basiliximab for graft-versus-host disease (GVHD) prophylaxis in 10 patients with leukemia was retrospectively compared to ATG for GVHD prophylaxis in 24 patients. Results: All the patients achieved neutrophil engraftment. One patient in the ATG group did not achieve platelet engraftment. The incidence of grade II-IV and grade III-IV acute GVHD was 30 and 20%, respectively, in the basiliximab group and 16.7 and 4.2%, respectively, in the ATG group (P > 0.05). Extensive cGVHD developed in 40 and 22.2% of patients in the basiliximab group and ATG group, respectively (P > 0.05). Basiliximab resulted in mild infection and a low incidence (10%) of infection-related mortality; ATG resulted in relative severe infection with 29.2% infection-related mortality (P > 0.05). During the follow-up period, 20% of the basiliximab group and 22.7% of the ATG group relapsed (P > 0.05). In the basiliximab group and the ATG group, the 3-year accumulative overall survival rate was, respectively, 80 and 52.5% and the 3-year leukemia-free survival, respectively, was 60 and 49.6% (P > 0.05). Discussion: The incidences of grade II-IV and grade III-IV aGVHD in the basiliximab group were similar to those in halpoidentical HSCT containing ATG. Compared to the ATG group, the basiliximab group had a lower rate of transplantation-related mortality and better long-term survival, but without statistical significance. Conclusion: The prophylactic regimen of basiliximab with haploidentical HSCT against GVHD seems safe and promising. More studies needed to verify this.