GVHD
Published on October 22, 2024
Haploidentical-HCT compared with MSD-HCT, with PTCy GVHD prophylaxis
by Blood Advances
Mehta RS, Ramdial JL, Kebriaei P, et al. Haploidentical Versus HLA-Matched Sibling Donor HCT With PTCy Prophylaxis: HLA Factors and Donor Age Considerations. Blood Advances. 2024; (doi: 10.1182/bloodadvances.2024013853).
Although HLA-matched sibling donors (MSDs) are considered the gold standard for hematopoietic cell transplantation (HCT), evidence suggests comparable outcomes are possible with haploidential donors. The analysis included 1,052 haploidentical donors and 400 MSDs, all of whom received posttransplant cyclophosphamide-based prophylaxis against graft-versus-host disease. The results revealed that the haploidentical cohort performed on par with the MSD group. Overall survival (OS) [hazard ratio (HR), [95% confidence interval] 0.94, [0.78-1.14], p=.54], non-relapse mortality (HR 0.98 [0.72-1.32], p=.87), and relapse (HR 0.87, [0.70-1.08], p=.20) in the haploidentical group were similar to that of the MSD group, especially when younger donors were involved. Not only was younger donor age a key predictor of improved OS, but significantly superior OS (HR 0.65, [0.48-0.90], p=.009) was observed in HCT patients ≥50 years who were paired with haploidentical B-leader matched donors <35 years, as compared with older MSDs.
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