Young unrelated donors confer a survival advantage for patients with myeloid malignancies compared to older siblings

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • German Cooperative Transplant Study Group - (Autor:in)
  • Medizinische Klinik und Poliklinik I
  • DKMS Clinical Trials Unit gGmbH
  • Universitätsklinikum Frankfurt
  • Universitätsklinikum Halle
  • Universitätsmedizin Mainz
  • Universitätsklinikum Hamburg-Eppendorf (UKE)
  • Universitätsklinikum Tübingen
  • Universitätsklinikum Münster
  • Universitätsklinikum Essen
  • Universitätsklinikum Schleswig-Holstein Campus Kiel
  • Universitätsklinikum Aachen
  • Universitätsklinikum Augsburg
  • DRK-Blutspendedienst Baden-Württemberg - Hessen
  • Universitätsklinikum Ulm

Abstract

Donor age is one factor to optimize allogeneic hematopoietic cell transplantation (alloHCT). Therefore, we investigated whether young unrelated donors (UD) provide a benefit for older patients with myeloid malignancies compared to HLA-identical sibling donors (MSD). We performed a retrospective registry study on patients ≥50 years who received a first alloHCT between 2010 and 2020. We compared event-free survival (EFS) of patients who were transplanted from MSD aged ≥50 years versus UD aged ≤35 years who were HLA-compatible for HLA-A, -B, -C, and -DRB1. In total, we analyzed data from 3460 patients. With multivariable adjustment EFS (HR 0.86, p = 0.003), OS (HR 0.82, p < 0.001), and risk of relapse (HR 0.84, p = 0.018) were significantly better for HLA-compatible UD compared to MSD. No survival advantage was found, when UD with unfavorable sex or CMV constellation were compared to MSD with favorable constellations. In a meta-analysis on 9905 patients with myeloid malignancies, including ours, we found reduced risk of relapse (pooled HR 0.78, p = 0.006) and better EFS (pooled HR 0.89, p < 0.001) for young matched UD versus MSD. To select young HLA-compatible UD over older MSD may reduce relapse risk and improve survival for older patients with myeloid malignancies.

Details

OriginalspracheEnglisch
Seiten (von - bis)2523-2532
Seitenumfang10
FachzeitschriftLeukemia
Jahrgang39
Ausgabenummer10
PublikationsstatusVeröffentlicht - Okt. 2025
Peer-Review-StatusJa

Externe IDs

PubMedCentral PMC12463653
Scopus 105016601633

Schlagworte

Schlagwörter

  • Humans, Male, Female, Siblings, Middle Aged, Unrelated Donors, Retrospective Studies, Adult, Hematopoietic Stem Cell Transplantation/mortality, Aged, Survival Rate, Age Factors, Transplantation, Homologous, Prognosis, Registries, Follow-Up Studies, Graft vs Host Disease/etiology