Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation
Abstract: Allogeneic hematopoietic stem cell transplantation (HSCT) from HLA-matched donors is the gold standard. However, haploidentical stem cell transplantation using posttransplant cyclophosphamide (PTCY-haplo) and cord blood transplants (CBTs) are alternatives when HLA-matched donors are not av...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
|
| Series: | Blood Advances |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2473952925001673 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850119986705596416 |
|---|---|
| author | Takashi Nagayama Shin-ichiro Fujiwara Satoshi Nishiwaki Fumiya Wada Naoyuki Uchida Masatsugu Tanaka Mamiko Sakata-Yanagimoto Makoto Onizuka Kazuya Ishiwata Yuta Hasegawa Shuichi Ota Noriko Doki Hirohisa Nakamae Tetsuya Nishida Toshiro Kawakita Masashi Sawa Masahito Tokunaga Fumihiko Ishimaru Takahiro Fukuda Yoshinobu Kanda Yoshiko Atsuta Hideki Nakasone |
| author_facet | Takashi Nagayama Shin-ichiro Fujiwara Satoshi Nishiwaki Fumiya Wada Naoyuki Uchida Masatsugu Tanaka Mamiko Sakata-Yanagimoto Makoto Onizuka Kazuya Ishiwata Yuta Hasegawa Shuichi Ota Noriko Doki Hirohisa Nakamae Tetsuya Nishida Toshiro Kawakita Masashi Sawa Masahito Tokunaga Fumihiko Ishimaru Takahiro Fukuda Yoshinobu Kanda Yoshiko Atsuta Hideki Nakasone |
| author_sort | Takashi Nagayama |
| collection | DOAJ |
| description | Abstract: Allogeneic hematopoietic stem cell transplantation (HSCT) from HLA-matched donors is the gold standard. However, haploidentical stem cell transplantation using posttransplant cyclophosphamide (PTCY-haplo) and cord blood transplants (CBTs) are alternatives when HLA-matched donors are not available. Using Japanese registry data, we evaluated the impact of haploidentical donor age on posttransplant outcomes by comparing PTCY-haplo and CBT. We analyzed data for 5161 patients aged 16 to 70 years who received their first HSCT for acute leukemia, myelodysplastic syndrome, or chronic myeloid leukemia. Haploidentical donors were categorized as “younger” (aged <40 years) or “older” (aged ≥40 years), and the patients were divided into younger (aged <50 years) and older (aged ≥50 years) cohorts. In the older cohort, PTCY-haplo from younger donors had better overall survival (OS; 55.5% vs 50.8%, P = .006), lower nonrelapse mortality (NRM; 17.3% vs 28.6%, P < .001), and higher relapse rates (33.0% vs 24.9%, P = .017) than with CBT. PTCY-haplo from older donors had comparable OS (44.1% vs 50.8%, P = 1.00), NRM (27.3% vs 28.6%, P = 1.00), and relapse (29.2% vs 24.9%, P = .90) to that with CBT. In the younger cohort, PTCY-haplo from younger and older donors showed OS, NRM, and relapse comparable with CBT. In the older cohort, cumulative incidence of acute graft-versus-host disease (GVHD) was higher with CBT than with PTCY-haplo, regardless of donor age. However, in the younger cohort, acute GVHD was lower in PTCY-haplo from younger donors than with CBT. PTCY-haplo from younger donors to older patients offers better clinical outcomes than CBT. |
| format | Article |
| id | doaj-art-72576212efa34824afe91a8dd4dc8e21 |
| institution | OA Journals |
| issn | 2473-9529 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Blood Advances |
| spelling | doaj-art-72576212efa34824afe91a8dd4dc8e212025-08-20T02:35:30ZengElsevierBlood Advances2473-95292025-07-019133226323710.1182/bloodadvances.2024014938Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantationTakashi Nagayama0Shin-ichiro Fujiwara1Satoshi Nishiwaki2Fumiya Wada3Naoyuki Uchida4Masatsugu Tanaka5Mamiko Sakata-Yanagimoto6Makoto Onizuka7Kazuya Ishiwata8Yuta Hasegawa9Shuichi Ota10Noriko Doki11Hirohisa Nakamae12Tetsuya Nishida13Toshiro Kawakita14Masashi Sawa15Masahito Tokunaga16Fumihiko Ishimaru17Takahiro Fukuda18Yoshinobu Kanda19Yoshiko Atsuta20Hideki Nakasone21Department of Hematology/Oncology, Kurashiki Central Hospital, Kurashiki, Japan; Division of Cell Transplantation and Transfusion, Jichi Medical University, Shimotsuke, JapanDivision of Cell Transplantation and Transfusion, Jichi Medical University, Shimotsuke, Japan; Correspondence: Shin-ichiro Fujiwara, Division of Cell Transplantation and Transfusion, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan;Department of Advanced Medicine, Nagoya University Hospital, Nagoya, JapanDepartment of Hematology, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Tokyo, JapanDepartment of Hematology, Kanagawa Cancer Center, Yokohama, JapanDepartment of Hematology, University of Tsukuba Hospital, Tsukuba, JapanDepartment of Hematology and Oncology, Tokai University School of Medicine, Isehara, JapanDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Kawasaki, JapanDepartment of Hematology, Hokkaido University Hospital, Sapporo, JapanDepartment of Hematology, Sapporo Hokuyu Hospital, Sapporo, JapanDivision of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Tokyo, JapanDepartment of Hematology, Osaka Metropolitan University Hospital, Osaka, JapanDepartment of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, JapanDepartment of Hematology, NHO Kumamoto Medical Center, Kumamoto, JapanDepartment of Hematology and Oncology, Anjo Kosei Hospital, Anjo, JapanDepartment of Hematology, Imamura General Hospital, Kagoshima, JapanJapanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, JapanDepartment of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, JapanDivision of Hematology, Jichi Medical University, Shimotsuke, JapanJapanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, JapanDivision of Emerging Medicine for Integrated Therapeutics, Center for Molecular Medicine, Jichi Medical University, Shimotsuke, JapanAbstract: Allogeneic hematopoietic stem cell transplantation (HSCT) from HLA-matched donors is the gold standard. However, haploidentical stem cell transplantation using posttransplant cyclophosphamide (PTCY-haplo) and cord blood transplants (CBTs) are alternatives when HLA-matched donors are not available. Using Japanese registry data, we evaluated the impact of haploidentical donor age on posttransplant outcomes by comparing PTCY-haplo and CBT. We analyzed data for 5161 patients aged 16 to 70 years who received their first HSCT for acute leukemia, myelodysplastic syndrome, or chronic myeloid leukemia. Haploidentical donors were categorized as “younger” (aged <40 years) or “older” (aged ≥40 years), and the patients were divided into younger (aged <50 years) and older (aged ≥50 years) cohorts. In the older cohort, PTCY-haplo from younger donors had better overall survival (OS; 55.5% vs 50.8%, P = .006), lower nonrelapse mortality (NRM; 17.3% vs 28.6%, P < .001), and higher relapse rates (33.0% vs 24.9%, P = .017) than with CBT. PTCY-haplo from older donors had comparable OS (44.1% vs 50.8%, P = 1.00), NRM (27.3% vs 28.6%, P = 1.00), and relapse (29.2% vs 24.9%, P = .90) to that with CBT. In the younger cohort, PTCY-haplo from younger and older donors showed OS, NRM, and relapse comparable with CBT. In the older cohort, cumulative incidence of acute graft-versus-host disease (GVHD) was higher with CBT than with PTCY-haplo, regardless of donor age. However, in the younger cohort, acute GVHD was lower in PTCY-haplo from younger donors than with CBT. PTCY-haplo from younger donors to older patients offers better clinical outcomes than CBT.http://www.sciencedirect.com/science/article/pii/S2473952925001673 |
| spellingShingle | Takashi Nagayama Shin-ichiro Fujiwara Satoshi Nishiwaki Fumiya Wada Naoyuki Uchida Masatsugu Tanaka Mamiko Sakata-Yanagimoto Makoto Onizuka Kazuya Ishiwata Yuta Hasegawa Shuichi Ota Noriko Doki Hirohisa Nakamae Tetsuya Nishida Toshiro Kawakita Masashi Sawa Masahito Tokunaga Fumihiko Ishimaru Takahiro Fukuda Yoshinobu Kanda Yoshiko Atsuta Hideki Nakasone Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation Blood Advances |
| title | Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation |
| title_full | Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation |
| title_fullStr | Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation |
| title_full_unstemmed | Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation |
| title_short | Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation |
| title_sort | impact of haplo donor age on transplant outcomes a comparative analysis of haploidentical vs cord blood transplantation |
| url | http://www.sciencedirect.com/science/article/pii/S2473952925001673 |
| work_keys_str_mv | AT takashinagayama impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT shinichirofujiwara impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT satoshinishiwaki impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT fumiyawada impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT naoyukiuchida impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT masatsugutanaka impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT mamikosakatayanagimoto impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT makotoonizuka impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT kazuyaishiwata impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT yutahasegawa impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT shuichiota impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT norikodoki impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT hirohisanakamae impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT tetsuyanishida impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT toshirokawakita impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT masashisawa impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT masahitotokunaga impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT fumihikoishimaru impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT takahirofukuda impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT yoshinobukanda impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT yoshikoatsuta impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation AT hidekinakasone impactofhaplodonorageontransplantoutcomesacomparativeanalysisofhaploidenticalvscordbloodtransplantation |