Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction: Over the last decades, the donor network for hematopoietic cell transplantation (HCT) has grown exponentially, including unrelated and haploidentical (Haplo) donors. This study aimed to describe HCT outcomes with MSD, Haplo, and matched unrelated donors (MUD) in an early period of Haplo with posttransplant cyclophosphamide in a developing country with a large unrelated donor registry. Methods: This study was conducted in collaboration with the CIBMTR. We included patients with acute leukemias undergoing HCT between 2014-2018. Results: With 595 patients, 2-year overall survival (OS) was 69% for the MSD, 65% for the Haplo, and 71% for MUD (p=0.24) in CR1, confirmed in multivariable analysis. Relapse rate was lower for MUD (HR=0.35, p=0.0005) than MSD in patients with CR2+, leading to higher OS. Relapse was also higher with Haplo compared with MUD (HR=2.06, p=0.03). Discussion: Only survival bias can explain these findings in CR2+, suggesting some high-risk MUD patients, in which HCT timing is crucial, may not achieve HCT. Alternative donors were associated with higher non-relapse mortality, while PTCy-based Haplo offered the best protection against chronic graft-versus-host disease. Our study suggests Haplo and MUD are acceptable options for patients lacking MSD in developing countries like ours.
Source: Frontiers in Oncology
Authors: Adriana Seber, Leonardo Javier Arcuri, Vergilio Rensi Colturato, Mair Pedro Souza, Yana Augusta Novis Zogbi, Vaneuza Funke, Decio Lerner, Maria Cristina Macedo, Liane Daudt, Mariana Nassif Kerbauy, Victor Gottardello Zecchin, Fernando Barroso Duarte, Ricardo Rabello Chiattone, Rodolfo Daniel de Almeida Soares, Gustavo Bettarello, Antonio Vaz de Macedo, Eduardo Paton, Tatiana Dias Marconi Monteiro, Jayr Schmidt Filho, Claudia Caceres Astigarraga, Phillip Scheinberg, Afonso Celso Vigorito, Carmen Silvia Vieitas Vergueiro, Anderson Simione, Shahrukh Hashmi, Wael Saber, Jinalben Patel, Carmem Maria Sales Bonfim, Marcelo Pasquini, Mary Evelyn Flowers, Nelson Hamerschlak
Institutions: Hospital Samaritano de São Paulo, Hospital Israelita Albert Einstein, Hospital Amaral Carvalho, Hospital Sírio-Libanês, Universidade Federal do Paraná, Instituto Nacional de Câncer - INCA, Universidade Federal do Rio Grande do Sul, Beneficência Portuguesa de São Paulo, Universidade Federal do Ceará, Universidade Federal do Rio Grande do Norte, AC Camargo Hospital, Universidade Estadual de Campinas (UNICAMP), Medical College of Wisconsin, Duke University, Fred Hutch Cancer Center
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4409465504