A comparison of haplo-HCT and MSD-HCT for myelofibrosis
Jain T, Estrada-Merly N, Salas MQ, et al. Donor Types and Outcomes of Transplantation in Myelofibrosis: A CIBMTR Study. Blood Advances. 2024; (doi: 10.1182/bloodadvances.2024013451).
Haploidentical donors are becoming more common for hematopoietic cell transplantations (HCT) in patients with myelofibrosis. Although matched sibling donors (MSD) produce the best outcomes, researchers assure that haplo-HCT is acceptable. MSD is not always feasible, particularly for ethnic minorities who are underrepresented in the donor registries and must rely on a different type of donor. Investigators studied 2013-19 registry data from the Center for International Blood and Marrow Transplant Research to identify 1,032 patients who underwent HCT for myelofibrosis. Notably, 38% of patients in the haploidentical-HCT sample were not White/Caucasian. MSD-HCTs correlated to superior overall survival (OS) in the first 3 months post-procedure, owing to fewer graft failures. Hazard ratios for haplo-HCT, HCT with matched unrelated donors, and HCT with mismatched unrelated donors were 5.80, 4.50, and 5.13, respectively — a difference that was not considered significant. The results underscore that even as MSD-HCT is optimal for myelofibrosis, OS rates with haplo-HCT compare to those with MSD-HCT, making it a viable option.