Selection of unrelated donors for allogeneic transplantation using post-transplant cyclophosphamide in acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Conflicting data exist on the impact of mismatched unrelated donor (MMUD) compared to matched unrelated donor (MUD) in hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PTCy), highlighting the need for disease-specific research. We conducted a retrospective analysis of...
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Ferrata Storti Foundation
2025-07-01
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| Series: | Haematologica |
| Online Access: | https://haematologica.org/article/view/12195 |
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| author | Jaime Sanz Allain-Thibeault Ferhat Alexander Kulagin Nicolaus Kröger Montserrat Rovira Lorenzo Lazzari Mutlu Arat Juan Montoro Jurjen Versluis Péter Reményi Simona Sica Didier Blaise Muhammad Ameer Saif Jan Vydra Franca Fagioli Erfan Nur Sebastian Giebel Zina Peric Eolia Brissot Arnon Nagler Simona Piemontese Mohamad Mohty Fabio Ciceri |
| author_facet | Jaime Sanz Allain-Thibeault Ferhat Alexander Kulagin Nicolaus Kröger Montserrat Rovira Lorenzo Lazzari Mutlu Arat Juan Montoro Jurjen Versluis Péter Reményi Simona Sica Didier Blaise Muhammad Ameer Saif Jan Vydra Franca Fagioli Erfan Nur Sebastian Giebel Zina Peric Eolia Brissot Arnon Nagler Simona Piemontese Mohamad Mohty Fabio Ciceri |
| author_sort | Jaime Sanz |
| collection | DOAJ |
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Conflicting data exist on the impact of mismatched unrelated donor (MMUD) compared to matched unrelated donor (MUD) in hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PTCy), highlighting the need for disease-specific research. We conducted a retrospective analysis of donor characteristics in 350 patients with acute lymphoblastic leukemia (ALL) in complete remission (CR) who received 8/8 human leukocyte antigen (HLA)-matched MUD and 7/8 HLA-matched MMUD. The primary endpoint was leukemia-free survival (LFS). The median age was 37 years (range, 18-76), with 231 (66%) in first CR, and 280 (80%) diagnosed with B-cell ALL. The median donor age was 28 years (range, 18-57), with 237 (68%) MUD and 113 (32%) MMUD. The use of MUD or MMUD did not have a significant impact on LFS or other transplant outcomes. Among other donorrelated variables, CMV-negative donor for a CMV-negative recipient was associated with improved LFS (HR 0.55; 95% CI 0.32-0.96) and overall survival (HR 0.52; 95% CI 0.28-1), while older donor age showed an increased risk of acute graft-versus-host disease (GVHD) grade III-IV (HR 1.7; 95% CI 1.1-2.64) and female donor to male recipient combination increased the risk of grade II-IV acute GvHD (HR 1.78; 95% CI 1.05-3). In conclusion, non-HLA donor characteristics rather than HLA matching should be prioritized to guide unrelated donor selection for ALL patients in the PTCy HCT setting.
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| format | Article |
| id | doaj-art-4cb1d0970eea455f89c6130349edbdf8 |
| institution | Kabale University |
| issn | 0390-6078 1592-8721 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Ferrata Storti Foundation |
| record_format | Article |
| series | Haematologica |
| spelling | doaj-art-4cb1d0970eea455f89c6130349edbdf82025-08-20T03:58:39ZengFerrata Storti FoundationHaematologica0390-60781592-87212025-07-01999110.3324/haematol.2025.287750Selection of unrelated donors for allogeneic transplantation using post-transplant cyclophosphamide in acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow TransplantationJaime Sanz0Allain-Thibeault Ferhat1Alexander Kulagin2Nicolaus Kröger3Montserrat Rovira4Lorenzo Lazzari5Mutlu Arat6Juan Montoro7Jurjen Versluis8Péter Reményi9Simona Sica10Didier Blaise11Muhammad Ameer Saif12Jan Vydra13Franca Fagioli14Erfan Nur15Sebastian Giebel16Zina Peric17Eolia Brissot18Arnon Nagler19Simona Piemontese20Mohamad Mohty21Fabio Ciceri22Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia Departament de Medicina Universitat de Valencia, CIBERONC, Instituto Carlos III, MadridEBMT Paris Office, Hospital Saint Antoine, ParisRM Gorbacheva Research Institute, Pavlov University, Saint PetersburgDepartment for Stem Cell Transplantation, University Medical Center Hamburg/GermanyBMT Unit, Department of Haematology, Institute of Haematology and Oncology, IDIBAPS, Hospital clinic, University of Barcelona, Barcelona, Spain; Josep Carreras Leukaemia Research Foundation, BarcelonaHematology and Bone Marrow transplant Unit, San Raffaele Scientific Institute IRCCS, MilanoDemiroglu Bilim University Istanbul Florence Nightingale Hospital, IstanbulHematology Department, Hospital Universitari i Politècnic La Fe, Valencia Departament de Medicina Universitat de Valencia, CIBERONC, Instituto Carlos III, MadridErasmus MC Cancer Institute, RotterdamDél-pesti Centrumkórház, BudapestDipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico A. Gemelli-IRCCS –Università cattolica Sacro CuoreProgramme de Transplantation &Therapie Cellulaire – MarseilleClatterbridge Cancer Centre Liverpool, LiverpoolInstitute of Hematology and Blood Transfusion, Prague, Czech RepublicOspedale Infantile Regina Margherita, University of Turin, TorinoAmsterdam UMC, University of Amsterdam, AmsterdamDepartment of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie National Research Institute of Oncology, GliwiceDepartment of hematology, University Hospital Centre Rijeka and School of Medicine, University of Rijeka, Rijeka, CroatiaHôpital Saint-Antoine, Sorbonne University, INSERM UMRs 938, ParisDivision of Hematology, Sheba Medical Center, HashomerHematology and Bone Marrow transplant Unit, San Raffaele Scientific Institute IRCCS, MilanoHôpital Saint-Antoine, Sorbonne University, INSERM UMRs 938, ParisHematology and Bone Marrow transplant Unit, San Raffaele Scientific Institute IRCCS, Milano, Italy; Vita-Salute San Raffaele University, Milano Conflicting data exist on the impact of mismatched unrelated donor (MMUD) compared to matched unrelated donor (MUD) in hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PTCy), highlighting the need for disease-specific research. We conducted a retrospective analysis of donor characteristics in 350 patients with acute lymphoblastic leukemia (ALL) in complete remission (CR) who received 8/8 human leukocyte antigen (HLA)-matched MUD and 7/8 HLA-matched MMUD. The primary endpoint was leukemia-free survival (LFS). The median age was 37 years (range, 18-76), with 231 (66%) in first CR, and 280 (80%) diagnosed with B-cell ALL. The median donor age was 28 years (range, 18-57), with 237 (68%) MUD and 113 (32%) MMUD. The use of MUD or MMUD did not have a significant impact on LFS or other transplant outcomes. Among other donorrelated variables, CMV-negative donor for a CMV-negative recipient was associated with improved LFS (HR 0.55; 95% CI 0.32-0.96) and overall survival (HR 0.52; 95% CI 0.28-1), while older donor age showed an increased risk of acute graft-versus-host disease (GVHD) grade III-IV (HR 1.7; 95% CI 1.1-2.64) and female donor to male recipient combination increased the risk of grade II-IV acute GvHD (HR 1.78; 95% CI 1.05-3). In conclusion, non-HLA donor characteristics rather than HLA matching should be prioritized to guide unrelated donor selection for ALL patients in the PTCy HCT setting. https://haematologica.org/article/view/12195 |
| spellingShingle | Jaime Sanz Allain-Thibeault Ferhat Alexander Kulagin Nicolaus Kröger Montserrat Rovira Lorenzo Lazzari Mutlu Arat Juan Montoro Jurjen Versluis Péter Reményi Simona Sica Didier Blaise Muhammad Ameer Saif Jan Vydra Franca Fagioli Erfan Nur Sebastian Giebel Zina Peric Eolia Brissot Arnon Nagler Simona Piemontese Mohamad Mohty Fabio Ciceri Selection of unrelated donors for allogeneic transplantation using post-transplant cyclophosphamide in acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation Haematologica |
| title | Selection of unrelated donors for allogeneic transplantation using post-transplant cyclophosphamide in acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
| title_full | Selection of unrelated donors for allogeneic transplantation using post-transplant cyclophosphamide in acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
| title_fullStr | Selection of unrelated donors for allogeneic transplantation using post-transplant cyclophosphamide in acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
| title_full_unstemmed | Selection of unrelated donors for allogeneic transplantation using post-transplant cyclophosphamide in acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
| title_short | Selection of unrelated donors for allogeneic transplantation using post-transplant cyclophosphamide in acute lymphoblastic leukemia: An analysis by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation |
| title_sort | selection of unrelated donors for allogeneic transplantation using post transplant cyclophosphamide in acute lymphoblastic leukemia an analysis by the acute leukemia working party of the european society for blood and marrow transplantation |
| url | https://haematologica.org/article/view/12195 |
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