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Summary: This retrospective study analysed 106 acute myeloid leukaemia (AML) patients undergoing autologous haematopoietic stem cell transplantation (ASCT) to assess the impact of multiple small‐dose infusions of granulocyte‐colony‐stimulating factor (G‐CSF)‐mobilized haploidentical lymphocytes as post‐ASCT maintenance therapy. Among them, 50 patients received lymphocyte maintenance therapy, 21 received alternative maintenance therapy, and 35 received no maintenance therapy. Patients receiving lymphocyte maintenance therapy demonstrated significantly higher overall survival (OS) and disease‐free survival (DFS) compared to those without maintenance therapy, with 4‐year OS and DFS rates notably elevated. While there were no significant differences in recurrence rates among the three groups, lymphocyte maintenance therapy showcased particular benefits for intermediate‐risk AML patients, yielding significantly higher OS and DFS rates and lower relapse rates compared to alternative maintenance therapy and no maintenance therapy. The study suggests that multiple small‐dose infusions of G‐CSF‐mobilized haploidentical lymphocytes may offer promising outcomes for AML patients after ASCT, particularly for those classified as intermediate‐risk. These findings underscore the potential efficacy of lymphocyte maintenance therapy in reducing disease relapse and improving long‐term prognosis in this patient population. [ABSTRACT FROM AUTHOR]

Summary: Anti‐thymocyte globulin (ATG) or post‐transplant cyclophosphamide (PTCy)‐based regimens are widely used for graft‐versus‐host disease (GVHD) prophylaxis in haploidentical haematopoietic stem cell transplantation (haplo‐HSCT). To improve the effectiveness of GVHD prophylaxis in haploidentical peripheral blood stem cell transplantation (haplo‐PBSCT), we conducted a multicentre, randomized clinical trial to determine the efficacy of reduced‐dose PTCy (40 mg/kg/d on days 3 and 4) combined with low‐dose post‐transplant ATG (2.5 mg/kg on day 8)‐based GVHD prophylaxis (reduced‐dose PTCy/ATG) with fludarabine–busulfan–cytarabine (FBA) conditioning for patients with haematological malignancies. From 2018 to 2022, 122 patients from four institutions were randomly assigned 1:1 to either a reduced‐dose PTCy/ATG or a standard‐dose ATG group ('Beijing Protocol', ATG: 10 mg/kg). All patients achieved myeloid engraftment. Cumulative incidences of grade II–IV (11.5% vs 39.3%, p = 0.001) and grade III–IV (6.6% vs 24.6%, p = 0.014) acute GVHD at day 100 were significantly reduced in the reduced‐dose PTCy/ATG group. Furthermore, two‐year overall survival, disease‐free survival and GVHD‐free/relapse‐free survival were significantly improved in the reduced‐dose PTCy/ATG group (75.4% vs 54.1%, p = 0.021; 72.7% vs 55.0%, p = 0.044; 61.3% vs 42.3%, p = 0.022 respectively). Our results demonstrate that the addition of low‐dose ATG to reduced‐dose PTCy with FBA conditioning is a promising strategy in haplo‐PBSCT. [ABSTRACT FROM AUTHOR]