Outcomes of haploidentical transplants with PT-CY vs 10/10 MUD transplants with ATG in Germany
Year: 2024
Type: article
Study design: Observational Study
Abstract: ABSTRACT: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the best curative treatment modality for many malignant hematologic disorders. In the absence of a matched related donor, matched unrelated donors (MUDs) and haploidentical donors are the most important stem cell sources. In this registry-based retrospective study, we compared the outcomes of allo-HSCTs from 10/10 MUDs with antithymocyte globulin (ATG)-based regimens (n = 7050) vs haploidentical transplants (Haplo-Tx) using posttransplant cyclophosphamide (PT-CY Haplo; n = 487) in adult patients with hematologic malignancies between 2010 and 2020. Cox proportional hazard-and competing risks regression models were formed to compare the outcomes. Overall survival (OS), Disease-free survival (DFS), and graft-versus-host disease (GVHD)-free and relapse-free survival (GRFS) were superior for 10/10 MUDs (OS [hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.10-1.47; P = .001]; DFS [HR, 1.17; CI, 1.02-1.34; P = .022]; GRFS [HR, 1.34; CI, 1.19-1.50; P < .001]). The risk of acute GVHD (aGVHD) grade 2 to 4, aGVHD grade 3 to 4, and chronic GVHD (cGVHD) was higher in the PT-CY Haplo group than the 10/10 MUD group (aGVHD grade 2-4 [HR, 1.46; CI, 1.25-1.71; P < .001]; aGVHD grade 3-4 [HR, 1.74; CI, 1.37- 2.20; P < .001]; cGVHD [HR, 1.30; CI, 1.11-1.51; P = .001]). A lower incidence of relapse was observed in the PT-CY Haplo group (relapse: HR, 0.83; CI, 0.69-0.99; P = .038). Unrelated 10/10 matched transplantation with ATG leads to lower GVHD rates and improved survival rates compared with PT-CY Haplo transplantation in Germany.
Source: Blood Advances
Authors: Aysenur Arslan, Svenja Labuhn, Elisa Sala, Mark Ringhoffer, Johannes Schetelig, Thomas Schröder, Gesine Bug, Georg-Nikolaus Franke, Matthias Stelljes, Peter Dreger, Robert Zeiser, Daniel Teschner, Wolfgang Bethge, Matthias Eder, Matthias Edinger, Elisa Maria Amann, Christine Neuchel, Amelie Schmid-Möglich, Sandra Schmeller, Jan Beyersmann, Hubert Schrezenmeier, Joannis Mytilineos, Nicolaus Kröger, Daniel Fürst
Institutions: Universität Ulm, German Red Cross, University Hospital Ulm, Städtisches Klinikum Karlsruhe, University Hospital Carl Gustav Carus, Technische Universität Dresden, Essen University Hospital, Goethe University Frankfurt, Leipzig University, University of Münster, University Hospital Münster, Heidelberg University, University Hospital Heidelberg, University of Freiburg, University Medical Center Freiburg, University of Würzburg, Universitätsklinikum Würzburg, Universitätsklinikum Tübingen, University of Tübingen, Medizinische Hochschule Hannover, University Hospital Regensburg, Leibniz Institute for Immunotherapy, University of Regensburg, German National Bone Marrow Donor Registry, University Medical Center Hamburg-Eppendorf
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,000
Funder: Deutsche Forschungsgemeinschaft
OpenAlex ID: W4403151208