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Haploidentical versus matched unrelated donor transplants using post-transplantation cyclophosphamide for lymphomas

When using post-transplantation cyclophosphamide (PTCy) graft-versus-host disease (GVHD) prophylaxis for lymphoma patients, it is currently unknown whether a matched unrelated donor (MUD) or a haploidentical related donor is preferable if both are available. In this study we wanted to test whether u...

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Main Authors: Mussetti, Alberto (Author) , Kanate, Abraham S. (Author) , Wang, Tao (Author) , He, Meilun (Author) , Hamadani, Mehdi (Author) , Finel, Hervé (Author) , Boumendil, Ariane (Author) , Glass, Bertram (Author) , Castagna, Luca (Author) , Dominietto, Alida (Author) , McGuirk, Joseph (Author) , Blaise, Didier (Author) , Gülbas, Zafer (Author) , Diez-Martin, Jose (Author) , Marsh, Steven G. E. (Author) , Paczesny, Sophie (Author) , Gadalla, Shahinaz M. (Author) , Dreger, Peter (Author) , Zhang, Mei-Jie (Author) , Spellman, Stephen R. (Author) , Lee, Stephanie J. (Author) , Bolon, Yung-Tsi (Author) , Sureda, Anna (Author)
Format: Article (Journal)
Language:English
Published: 28 February 2023
In: Transplantation and cellular therapy
Year: 2023, Volume: 29, Issue: 3, Pages: 184.e1-184.e9
ISSN:2666-6367
DOI:10.1016/j.jtct.2022.11.028
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jtct.2022.11.028
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S2666636722018012
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Author Notes:Alberto Mussetti, Abraham S. Kanate, Tao Wang, Meilun He, Mehdi Hamadani, Hervé Finel, Ariane Boumendil, Bertram Glass, Luca Castagna, Alida Dominietto, Joseph McGuirk, Didier Blaise, Zafer Gülbas, Jose Diez-Martin, Steven G. E. Marsh, Sophie Paczesny, Shahinaz M. Gadalla, Peter Dreger, Mei-Jie Zhang, Stephen R. Spellman, Stephanie J. Lee, Yung-Tsi Bolon, Anna Sureda
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Summary:When using post-transplantation cyclophosphamide (PTCy) graft-versus-host disease (GVHD) prophylaxis for lymphoma patients, it is currently unknown whether a matched unrelated donor (MUD) or a haploidentical related donor is preferable if both are available. In this study we wanted to test whether using a haploidentical donor has the same results of a MUD. A total of 2140 adults (34% Center for International Blood and Marrow Transplant Research, 66% European Society for Blood and Marrow Transplantation registry) aged ≥18 years who received their first haploidentical hematopoietic cell transplantation (haplo-HCT) or MUD-HCT (8/8 match at HLA-loci A, B, C, and DRB1) for lymphoma using PTCy-based GVHD prophylaxis from 2010 to 2019 were retrospectively analyzed. The majority of both MUD and haploidentical HCTs received reduced intensity/nonmyeloablative conditioning (74% and 77%, respectively) and used a peripheral blood stem cell graft (91% and 60%, respectively) and a 3-drug GVHD prophylaxis (PTCy + calcineurin inhibitor + MMF in 54% and 90%, respectively). Haploidentical HCT has less favorable results versus MUD cohort in terms of overall mortality (hazard ratio [HR= = 1.69; 95% confidence interval [CI], 1.30-2.27; P < .001), progression-free survival (HR=1.39; 95% CI, 1.10-1.79; P = .008), nonrelapse mortality (HR = 1.93; 95% CI, 1.21-3.07; P = .006), platelet engraftment (HR = 0.69; 95% CI, 0.59-0.80; P < .001), acute grade 2-4 GVHD incidence (HR = 1.65; 95% CI, 1.28-2.14; P < .001), and chronic GVHD (HR = 1.79; 95% CI, 1.30-2.48, P < .001). No significant differences were observed in terms of relapse and neutrophil engraftment. Adjusting for propensity score yielded similar results. Whenever MUD is available in a timely manner, it should be preferred over a haploidentical donor when using PTCy-based GVHD prophylaxis for patients with lymphoma.
Item Description:Online verfügbar 25. Dezember 2022, Artikelversion 28. Februar 2023
Gesehen am 11.07.2023
Physical Description:Online Resource
ISSN:2666-6367
DOI:10.1016/j.jtct.2022.11.028

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