Impact of Donor Type on Outcomes After Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis: A Study on Behalf of the Chronic Malignancies Working Party of the EBMT
Year: 2025
Type: article
Study design: Observational Study
Abstract: Selecting the optimal donor is crucial for optimizing results of allogeneic hematopoietic cell transplantation (allo-HCT). We analyzed outcomes based on donor type in 2809 myelofibrosis (MF) patients undergoing first allo-HCT between 2015 and 2021 at EBMT centers. Study outcomes included overall survival (OS), progression-free survival (PFS), relapse, non-relapse mortality (NRM), engraftment, and graft-versus-host disease (GvHD). Four groups were compared: matched sibling donor (MSD, n = 742), matched unrelated donor (MUD, n = 1401), mismatched unrelated donor (MMUD, n = 379) and haploidentical donor (HD, n = 287). After a median follow-up of 33.5 months, 3-year OS rates were 65.8%, 61.5%, 53.2%, and 57.7% for MSD, MUD, MMUD, and HD, respectively. Multivariable analyses (MSD as reference) showed that donor type significantly correlated with OS (HR: 1.63 for MMUD, HR: 1.42 for HD), PFS (HR: 1.38 for MMUD), NRM (HR: 1.73 for MMUD, HR: 1.47 for HD), engraftment (HR: 0.72 for MMUD, HR: 0.40 for HD), grade 2-4 acute GvHD (HR: 1.53 for MUD, HR: 1.69 for MMUD, HR: 1.49 for HD), and extensive chronic GvHD (HR: 0.77 for MUD, HR: 0.65 for HD). Donor type was not associated with relapse risk. In patients over 60 years, correlations between donor type and outcomes were consistent with those in the overall study population. In summary, with current practices, MF patients receiving MSD or MUD grafts achieve comparable outcomes. In contrast, MMUD and HD transplants have worse OS due to increased NRM. MMUD transplants have a higher risk of GvHD than HD transplants, but this difference seems to disappear with post-transplant cyclophosphamide.
Source: American Journal of Hematology
DOI: 10.1002/ajh.70049
Authors: Juan Carlos Hernández‐Boluda, Vipul Sheth, Simona Iacobelli, Linda Koster, Nicolaus Kröger, Patrizia Chiusolo, Thomas Schroeder, Marie Robin, Massimiliano Gambella, Didier Blaise, Henrik Sengeloev, Jakob Passweg, Mattias Stelljes, Robert Zeiser, Ibrahim Yakoub‐Agha, Andrew Clark, Urpu Salmenniemi, Piero Galieni, Werner Rabitsch, Kavita Raj, Joanna Drozd‐Sokolowska, Giorgia Battipaglia, Nicola Polverelli, Tomasz Czerw, Donal P. McLornan
Institutions: Universitat de València, Rajiv Gandhi Cancer Institute and Research Centre, Sapienza University of Rome, European Society for Blood and Marrow Transplantation, Universität Hamburg, University Medical Center Hamburg-Eppendorf, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Essen University Hospital, Hôpital Saint-Louis, Ospedale Policlinico San Martino, Rigshospitalet, University Hospital of Basel, University of Münster, University of Freiburg, Inserm, Université de Lille, Centre Hospitalier Universitaire de Lille, Institute for Translational Research in Inflammation, Glasgow Royal Infirmary, Helsinki University Hospital, Medical University of Vienna, University College London Hospitals NHS Foundation Trust, University College London, Medical University of Warsaw, Central Clinical Hospital, Federico II University Hospital, University of Naples Federico II, Policlinico San Matteo Fondazione, The Maria Sklodowska-Curie National Research Institute of Oncology
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,450
OpenAlex ID: W4413826313