Science Highlights
Published on September 19, 2024
Effect of donor age vs. DP matching on URD donor selection
by Blood Advances
Mehta RS, Petersdorf EW, Wang T, et al. Interplay Between Donor Age and HLA-DP Matching in 10/10 HLA-Matched Unrelated Donor HCT. Blood Advances. 2024; (doi: 10.1182/bloodadvances.2024013677).
For patients undergoing hematopoietic cell transplantation (HCT) from a 10/10 HLA-matched unrelated donor, scientists agree that the age of the donor matters more than T-cell epitope DP-matching. Within a sample of 10,783 HCT patients who received prophylaxis with calcineurin-inhibitor, investigators evaluated outcomes based on six different pairings of donor age and DP-matching. Specifically, the scenarios included DP-matched/younger donor, DP-matched/older donor, permissive-mismatched/younger donor, permissive-mismatched/older donor, non-permissive mismatched/younger donor, and non-permissive mismatched/older donor. Analysis determined that younger donor age, rather than DP-matching, correlated with better overall survival (OS). Use of donors with permissive mismatches achieved OS comparable to that observed with DP-matched donors, but the outcome favored younger donors over older ones. The research underscores the preference for DP-matched or permissive-mismatched donors younger than age 35 years. However, even in the case of non-permissive mismatches — which the study says should be avoided — OS with younger donors was better than with older donors.
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