Haploidentical versus matched unrelated donor transplants using post-transplantation cyclophosphamide for lymphomas / Alberto Mussetti, Abraham S. Kanate, Tao Wang, Meilun He, Mehdi Hamadani, Hervé Finel, Ariane Boumendil, Bertram Glass, Luca Castagna, Alida Dominietto, Joseph McGuirk, Didier Blaise, Zafer Gülbas, Jose Diez-Martin, Steven G. E. Marsh, Sophie Paczesny, Shahinaz M. Gadalla, Peter Dreger, Mei-Jie Zhang, Stephen R. Spellman, Stephanie J. Lee, Yung-Tsi Bolon, Anna Sureda
When using post-transplantation cyclophosphamide (PTCy) graft-versus-host disease (GVHD) prophylaxis for lymphoma patients, it is currently unknown whether a matched unrelated donor (MUD) or a haploidentical related donor is preferable if both are available. In this study we wanted to test whether using a haploidentical donor has the same results of a MUD. A total of 2140 adults (34% Center for International Blood and Marrow Transplant Research, 66% European Society for Blood and Marrow Transplantation registry) aged ≥18 years who received their first haploidentical hematopoietic cell transplantation (haplo-HCT) or MUD-HCT (8/8 match at HLA-loci A, B, C, and DRB1) for lymphoma using PTCy-based GVHD prophylaxis from 2010 to 2019 were retrospectively analyzed. The majority of both MUD and haploidentical HCTs received reduced intensity/nonmyeloablative conditioning (74% and 77%, respectively) and used a peripheral blood stem cell graft (91% and 60%, respectively) and a 3-drug GVHD prophylaxis (PTCy + calcineurin inhibitor + MMF in 54% and 90%, respectively). Haploidentical HCT has less favorable results versus MUD cohort in terms of overall mortality (hazard ratio [HR= = 1.69; 95% confidence interval [CI], 1.30-2.27; P < .001), progression-free survival (HR=1.39; 95% CI, 1.10-1.79; P = .008), nonrelapse mortality (HR = 1.93; 95% CI, 1.21-3.07; P = .006), platelet engraftment (HR = 0.69; 95% CI, 0.59-0.80; P < .001), acute grade 2-4 GVHD incidence (HR = 1.65; 95% CI, 1.28-2.14; P < .001), and chronic GVHD (HR = 1.79; 95% CI, 1.30-2.48, P < .001). No significant differences were observed in terms of relapse and neutrophil engraftment. Adjusting for propensity score yielded similar results. Whenever MUD is available in a timely manner, it should be preferred over a haploidentical donor when using PTCy-based GVHD prophylaxis for patients with lymphoma..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
28 February 2023 2023 |
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| Erschienen: |
28 February 2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Transplantation and cellular therapy - 29(2023), 3 vom: Feb., Seite 184.e1-184.e9 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mussetti, Alberto [VerfasserIn] |
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| Links: |
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| Themen: |
Haploidentical donor |
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| Anmerkungen: |
Online verfügbar 25. Dezember 2022, Artikelversion 28. Februar 2023 Gesehen am 11.07.2023 |
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| Umfang: |
9 |
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| doi: |
10.1016/j.jtct.2022.11.028 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Haploidentical versus matched unrelated donor transplants using post-transplantation cyclophosphamide for lymphomas |c Alberto Mussetti, Abraham S. Kanate, Tao Wang, Meilun He, Mehdi Hamadani, Hervé Finel, Ariane Boumendil, Bertram Glass, Luca Castagna, Alida Dominietto, Joseph McGuirk, Didier Blaise, Zafer Gülbas, Jose Diez-Martin, Steven G. E. Marsh, Sophie Paczesny, Shahinaz M. Gadalla, Peter Dreger, Mei-Jie Zhang, Stephen R. Spellman, Stephanie J. Lee, Yung-Tsi Bolon, Anna Sureda |
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| 520 | |a When using post-transplantation cyclophosphamide (PTCy) graft-versus-host disease (GVHD) prophylaxis for lymphoma patients, it is currently unknown whether a matched unrelated donor (MUD) or a haploidentical related donor is preferable if both are available. In this study we wanted to test whether using a haploidentical donor has the same results of a MUD. A total of 2140 adults (34% Center for International Blood and Marrow Transplant Research, 66% European Society for Blood and Marrow Transplantation registry) aged ≥18 years who received their first haploidentical hematopoietic cell transplantation (haplo-HCT) or MUD-HCT (8/8 match at HLA-loci A, B, C, and DRB1) for lymphoma using PTCy-based GVHD prophylaxis from 2010 to 2019 were retrospectively analyzed. The majority of both MUD and haploidentical HCTs received reduced intensity/nonmyeloablative conditioning (74% and 77%, respectively) and used a peripheral blood stem cell graft (91% and 60%, respectively) and a 3-drug GVHD prophylaxis (PTCy + calcineurin inhibitor + MMF in 54% and 90%, respectively). Haploidentical HCT has less favorable results versus MUD cohort in terms of overall mortality (hazard ratio [HR= = 1.69; 95% confidence interval [CI], 1.30-2.27; P < .001), progression-free survival (HR=1.39; 95% CI, 1.10-1.79; P = .008), nonrelapse mortality (HR = 1.93; 95% CI, 1.21-3.07; P = .006), platelet engraftment (HR = 0.69; 95% CI, 0.59-0.80; P < .001), acute grade 2-4 GVHD incidence (HR = 1.65; 95% CI, 1.28-2.14; P < .001), and chronic GVHD (HR = 1.79; 95% CI, 1.30-2.48, P < .001). No significant differences were observed in terms of relapse and neutrophil engraftment. Adjusting for propensity score yielded similar results. Whenever MUD is available in a timely manner, it should be preferred over a haploidentical donor when using PTCy-based GVHD prophylaxis for patients with lymphoma. | ||
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