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Outcomes of haploidentical transplants with PT-CY vs 10/10 MUD transplants with ATG in Germany

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 regi...

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Main Authors: Arslan, Aysenur (Author) , Labuhn, Svenja (Author) , Sala, Elisa (Author) , Ringhoffer, Mark (Author) , Schetelig, Johannes (Author) , Schröder, Thomas (Author) , Bug, Gesine (Author) , Franke, Georg-Nikolaus (Author) , Stelljes, Matthias (Author) , Dreger, Peter (Author) , Zeiser, Robert (Author) , Teschner, Daniel (Author) , Bethge, Wolfgang (Author) , Eder, Matthias (Author) , Edinger, Matthias (Author) , Amann, Elisa Maria (Author) , Neuchel, Christine (Author) , Schmid-Möglich, Amelie (Author) , Schmeller, Sandra (Author) , Beyersmann, Jan (Author) , Schrezenmeier, Hubert (Author) , Mytilineos, Joannis (Author) , Kröger, Nicolaus (Author) , Fürst, Daniel (Author)
Format: Article (Journal)
Language:English
Published: December 10 2024
In: Blood advances
Year: 2024, Volume: 8, Issue: 23, Pages: 6104-6113
ISSN:2473-9537
DOI:10.1182/bloodadvances.2024013719
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1182/bloodadvances.2024013719
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Author Notes: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, and Daniel Fürst, on behalf of the German Registry for Stem Cell Transplantation
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Summary: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.
Item Description:Online veröffentlicht: 3. Dezember 2024
Gesehen am 10.06.2025
Physical Description:Online Resource
ISSN:2473-9537
DOI:10.1182/bloodadvances.2024013719

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