Young unrelated donors confer a survival advantage for patients with myeloid malignancies compared to older siblings
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
- Department of Internal Medicine I
- DKMS Clinical Trials Unit
- University Hospital Frankfurt
- Martin Luther University Hospital
- University Medical Center Mainz
- University Hospital Hamburg Eppendorf
- University Hospital Tübingen
- University Hospital Münster
- University Hospital Essen
- University Hospital Schleswig-Holstein Campus Kiel
- University Hospital Aachen
- University Hospital Augsburg
- German Red Cross Blood Donation Service Baden-Württemberg/Hessen
- Ulm University Medical Center
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
| Original language | English |
|---|---|
| Pages (from-to) | 2523-2532 |
| Number of pages | 10 |
| Journal | Leukemia |
| Volume | 39 |
| Issue number | 10 |
| Publication status | Published - Oct 2025 |
| Peer-reviewed | Yes |
External IDs
| PubMedCentral | PMC12463653 |
|---|---|
| Scopus | 105016601633 |
Keywords
Keywords
- 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