Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 28;8(10):2332-2341.
doi: 10.1182/bloodadvances.2023012133.

Haploidentical stem cell donor choice for patients with acute myeloid leukemia: a study from the ALWP of the EBMT

Jaime Sanz  1   2   3 , Myriam Labopin  4 , Didier Blaise  5 , Anna Maria Raiola  6 , Alessandro Busca  7 , Jan Vydra  8 , Johanna Tischer  9 , Patrice Chevallier  10 , Stefania Bramanti  11 , Renato Fanin  12 , Gérard Socié  13 , Edouard Forcade  14 , Nicolaus Kröger  15 , Yener Koc  16 , Maija Itäla-Remes  17 , Marco Zecca  18 , Arnon Nagler  19 , Eolia Brissot  20 , Alexandros Spyridonidis  21 , Ali Bazarbachi  22 , Sebastian Giebel  23 , Simona Piemontese  24 , Mohamad Mohty  20 , Fabio Ciceri  24
Affiliations

Haploidentical stem cell donor choice for patients with acute myeloid leukemia: a study from the ALWP of the EBMT

Jaime Sanz et al. Blood Adv. .

Abstract

There is a paucity of information to guide the selection of the most suitable donor in haploidentical (Haplo) hematopoietic stem cell transplantation (HSCT). For this reason, from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, we conducted a retrospective analysis to evaluate the impact of Haplo donor characteristics on outcomes in patients with acute myeloid leukemia (AML) who received graft-versus-host disease prophylaxis with posttransplant cyclophosphamide (PTCy). The primary end point was graft-versus-host disease (GVHD)-free and relapse-free survival (GRFS). Overall, 2200 patients were included. The median age of donors was 37 years (range, 8-71); 820 (37%) were females, including 458 (21%) who were used for male recipients. In addition, 1631 donors (74%) donated peripheral blood (PB). Multivariable analysis identified certain donor-related risk factors with a detrimental impact on transplant outcomes. The use of PB, older donors' ages (>37 years), and female donors to male recipients negatively affected GRFS. Donor's age and female donor-to-male recipient combination also affected nonrelapse mortality, leukemia-free survival, and overall survival. In conclusion, donor-related variables significantly influence outcomes in patients with AML after Haplo-HSCT with PTCy. When possible, younger donors and male donors for male recipients should be prioritized. The use of bone marrow can additionally prevent GVHD.

PubMed Disclaimer

Conflict of interest statement

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

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Acute and chronic GVHD and GRFS according to the stem cell source.
Figure 2.
Figure 2.
Probability of LFS, OS, and GRFS according to donor age.
Figure 3.
Figure 3.
Probability of LFS, OS, and GRFS according to donor gender.
See this image and copyright information in PMC

References

    1. Passweg JR, Baldomero H, Chabannon C, et al. The EBMT activity survey on hematopoietic-cell transplantation and cellular therapy 2018: CAR-T’s come into focus. Bone Marrow Transplant. 2020;55(8):1604–1613. - PMC - PubMed
    1. Ciurea SO, Al Malki MM, Kongtim P, et al. The European Society for Blood and Marrow Transplantation (EBMT) consensus recommendations for donor selection in haploidentical hematopoietic cell transplantation. Bone Marrow Transplant. 2020;55(1):12–24. - PubMed
    1. McCurdy SR, Fuchs EJ. Selecting the best haploidentical donor. Semin Hematol. 2016;53(4):246–251. - PubMed
    1. Wang Y, Chang YJ, Xu LP, et al. Who is the best donor for a related HLA haplotype-mismatched transplant? Blood. 2014;124(6):843–850. - PubMed
    1. Stern M, Ruggeri L, Mancusi A, et al. Survival after T cell-depleted haploidentical stem cell transplantation is improved using the mother as donor. Blood. 2008;112(7):2990–2995. - PMC - PubMed