A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Young (<35 years) haploidentical versus old (≥35 years) mismatched unrelated donors and vice versa for allogeneic stem cell transplantation with post-transplant cyclophosphamide in patients with acute myeloid leukemia in first remission: a study on behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Tekijät: Nagler, Arnon; Labopin, Myriam; Swoboda, Ryszard; Blaise, Didier; Angelucci, Emanuele; Vydra, Jan; Corral, Lucía López; Bramanti, Stefania; Chiusolo, Patrizia; Kwon, Mi; Koc, Yener; Itäla-Remes, Maija; Martino, Massimo; Kulagin, Alexander; Busca, Alessandro; Ciceri, Fabio; Mohty, Mohamad
Kustantaja: Springer Nature
Julkaisuvuosi: 2024
Journal: Bone Marrow Transplantation
Tietokannassa oleva lehden nimi: Bone marrow transplantation
Lehden akronyymi: Bone Marrow Transplant
Vuosikerta: 59
Numero: 11
Aloitussivu: 1552
Lopetussivu: 1562
ISSN: 0268-3369
eISSN: 1476-5365
DOI: https://doi.org/10.1038/s41409-024-02400-5
Verkko-osoite: https://www.nature.com/articles/s41409-024-02400-5
We compared transplantation (HSCT) outcomes in AML patients undergoing HSCT with post-transplant cyclophosphamide (PTCy) in first complete remission from 1065 young (<35 years) haploidentical (Haplo) donors (yHaplo) vs. 147 old (≥35 years) mismatched unrelated donors (oMMUD) (first comparison) and from 271 young (<35 years) MMUD (yMMUD) vs. 1315 old (≥35 years) Haplo donors (oHaplo) (second comparison). Acute graft-versus-host disease (aGVHD) grades II-IV were significantly lower in the yHaplo vs. oMMUD group (HR = 0.62, p = 0.007). There were no significant differences in chronic GVHD, non-relapse mortality (NRM), relapse incidence, leukemia-free survival, overall survival, and GVHD-free and relapse-free survival. As for the second comparison, more patients in the oHaplo group had de novo AML, 86.6% vs. 81.9% in the yMMUD group (p = 0.044), while myeloablative conditioning was used more frequently in the yMMUD group, 53.3% vs. 46.8% in the oHaplo group (p = 0.049). aGVHD grades II-IV and NRM were significantly lower in the yMMUD vs. oHaplo group (HR = 0.69, p = 0.013 and HR = 0.60, p = 0.022). All other transplant outcomes did not differ. In conclusion, HSCT from young alternative donors (<35 years) results in a lower incidence of grades II-IV aGVHD. In addition, NRM is lower in HSCT from yMMUD compared to HSCT from oHaplo.
