Key Points

achieves outcomes similar to those of identical-sibling transplant for AML patients in first remission. • Haploidentical transplant is a valid postremission treatment of intermediate- or high-risk AML patients lacking an identical donor. The effects of HLA-identical sibling donor (ISD) hematopoietic stem cell transplan-tation (HSCT) on adults with intermediate- or high-risk acute myeloid leukemia (AML) in the first complete remission (CR1) are well established. Previous single-center studies have demonstrated similar survival after unmanipulated haploidentical donor (HID) vs ISD HSCT for hematologic malignancies. To test the hypothesis that hap-loidentical HSCT would be a valid option as postremission therapy for AML patients in CR1 lacking a matched donor, we designed a disease-specific, prospective, multi-center study. Between July 2010 and November 2013, 450 patients were assigned to undergo HID (231 patients) or ISD HSCT (219 patients) according to donor availability. Among HID and ISD recipients, the 3-year disease-free survival rate was 74 % and 78% (P5.34), respectively; theoverall survival ratewas79%and82 % (P5.36), respectively; cumulative incidences of relapse were 15 % and 15 % (P 5.98); and those of the nonrelapse-mortality were 13 % and 8 % (P 5.13), respectively. In conclusion, unma-nipulated haploidentical HSCT achieves outcomes similar to those of ISD HSCT for AMLpatients inCR1. Such transplantationwas demonstrated to be a valid alternative as postremission treatment of intermediate-or high-risk AML patients in CR1 lacking an identical donor. This trial was registered at www.chictr.org as #ChiCTR-OCH-10000940. (Blood. 2015;125(25):3956-3962