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. 2018 Sep 11;2(17):2254-2261.
doi: 10.1182/bloodadvances.2018021899.

Is a matched unrelated donor search needed for all allogeneic transplant candidates?

Stefan O Ciurea  1 , Maria Cecilia Borges Bittencourt  1 , Denái R Milton  2 , Kai Cao  3 , Piyanuch Kongtim  1 , Gabriela Rondon  1 , Julianne Chen  1 , Marina Konopleva  4 , Jorge M Ramos Perez  1 , Mohammed F El Shazly  1 , Majdi Aljadayeh  1 , Michele Alvarez  1 , Jin Im  1 , Gheath Al-Atrash  1 , Rohtesh Mehta  1 , Uday Popat  1 , Qaiser Bashir  1 , Betul Oran  1 , Chitra M Hosing  1 , Issa F Khouri  1 , Partow Kebriaei  1 , Richard E Champlin  1
Affiliations

Is a matched unrelated donor search needed for all allogeneic transplant candidates?

Stefan O Ciurea et al. Blood Adv. .

Abstract

Donor availability for allogeneic transplantation remains an important factor in determining outcomes of a successful transplant. We examined outcomes of 242 patients treated over 3 years who had a matched unrelated donor (MUD) search at our institution. One hundred sixty patients (66%) had a 10 of 10 MUD identified, and 85 (53%) proceeded to MUD transplantation. White patients and those with common haplotypes were more likely to have a MUD identified (odds ratio [OR], 7.4 [P < .0001]; OR, 41.6 [P < .0001]), and were more likely to proceed to transplantation with a MUD (OR, 11.2 [P < .0001]; OR, 85.1 [P = .002]). In addition, patients who were newly diagnosed/in remission at the time of MUD search had a higher probability of receiving a transplant (OR, 2.01 [P = .013]) and better progression-free survival (PFS; P < .0001). In multivariate analysis for patients who received a transplant, donor type did not influence PFS at 3 years, which was 40% for MUD and 57% for haploidentical transplants, respectively (hazard ratio, 1.2 [P = .50]). In conclusion, race, haplotype frequency, and disease status at the time of MUD search influence the probability of identifying a MUD and receiving a transplant. Patients with a low likelihood of receiving a MUD transplant may proceed to a haploidentical transplant as soon as indicated, as this approach does not appear to compromise transplant outcomes.

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Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
PFS according to type of transplant. CBT, cord blood transplant; HAPLO, haploidentical donor; MMUD, mismatched unrelated donor; SCT, stem cell transplant.
Figure 2.
Figure 2.
PFS according to race/haplotype frequency/disease status at the time of MUD search. C + C+ R/ND = white, common haplotype, and remission/newly diagnosed; C + C + PIF/R/R = white, common haplotype, and PIF/relapsed/refractory; C + U + R/ND = white, uncommon haplotype, remission/newly diagnosed; C + U + PIF/R/R = white, uncommon haplotype, and PIF/relapsed/refractory; O + C + R/ND = other race, common haplotype, and remission/newly diagnosed; O + C + PIF/R/R = other race, common haplotype, and PIF/relapsed/refractory; O + U + R/ND = other race, uncommon haplotype, remission/newly diagnosed; O + U + PIF/R/R = other race, uncommon haplotype, and PIF/relapsed/refractory.
See this image and copyright information in PMC

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