Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry
IntroductionOver the last decades, the donor network for hematopoietic cell transplantation (HCT) has grown exponentially, including unrelated and haploidentical (Haplo) donors. This study aimed to describe HCT outcomes with MSD, Haplo, and matched unrelated donors (MUD) in an early period of Haplo...
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2025-04-01
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| author | Adriana Seber Leonardo Javier Arcuri Vergilio Rensi Colturato Mair Pedro Souza Yana Augusta Novis Zogbi Vaneuza Funke Decio Lerner Maria Cristina Macedo Liane Daudt Mariana Nassif Kerbauy Victor Gottardello Zecchin Fernando Barroso Duarte Ricardo Rabello Chiattone Rodolfo Daniel de Almeida Soares Gustavo Bettarello Antonio Vaz de Macedo Eduardo Paton Tatiana Dias Marconi Monteiro Jayr Schmidt Filho Claudia Caceres Astigarraga Phillip Scheinberg Afonso Celso Vigorito Carmen Silvia Vieitas Vergueiro Anderson Simione Shahrukh Hashmi Wael Saber Jinalben Patel Carmem Maria Sales Bonfim Marcelo Pasquini Mary Evelyn Flowers Nelson Hamerschlak |
| author_facet | Adriana Seber Leonardo Javier Arcuri Vergilio Rensi Colturato Mair Pedro Souza Yana Augusta Novis Zogbi Vaneuza Funke Decio Lerner Maria Cristina Macedo Liane Daudt Mariana Nassif Kerbauy Victor Gottardello Zecchin Fernando Barroso Duarte Ricardo Rabello Chiattone Rodolfo Daniel de Almeida Soares Gustavo Bettarello Antonio Vaz de Macedo Eduardo Paton Tatiana Dias Marconi Monteiro Jayr Schmidt Filho Claudia Caceres Astigarraga Phillip Scheinberg Afonso Celso Vigorito Carmen Silvia Vieitas Vergueiro Anderson Simione Shahrukh Hashmi Wael Saber Jinalben Patel Carmem Maria Sales Bonfim Marcelo Pasquini Mary Evelyn Flowers Nelson Hamerschlak |
| author_sort | Adriana Seber |
| collection | DOAJ |
| description | IntroductionOver the last decades, the donor network for hematopoietic cell transplantation (HCT) has grown exponentially, including unrelated and haploidentical (Haplo) donors. This study aimed to describe HCT outcomes with MSD, Haplo, and matched unrelated donors (MUD) in an early period of Haplo with posttransplant cyclophosphamide in a developing country with a large unrelated donor registry.MethodsThis study was conducted in collaboration with the CIBMTR. We included patients with acute leukemias undergoing HCT between 2014-2018.ResultsWith 595 patients, 2-year overall survival (OS) was 69% for the MSD, 65% for the Haplo, and 71% for MUD (p=0.24) in CR1, confirmed in multivariable analysis. Relapse rate was lower for MUD (HR=0.35, p=0.0005) than MSD in patients with CR2+, leading to higher OS. Relapse was also higher with Haplo compared with MUD (HR=2.06, p=0.03).DiscussionOnly survival bias can explain these findings in CR2+, suggesting some high-risk MUD patients, in which HCT timing is crucial, may not achieve HCT. Alternative donors were associated with higher non-relapse mortality, while PTCy-based Haplo offered the best protection against chronic graft-versus-host disease. Our study suggests Haplo and MUD are acceptable options for patients lacking MSD in developing countries like ours. |
| format | Article |
| id | doaj-art-87e77926f65e4ccfad6a7f2bf635edea |
| institution | DOAJ |
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| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-87e77926f65e4ccfad6a7f2bf635edea2025-08-20T03:08:29ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-04-011510.3389/fonc.2025.15846311584631Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registryAdriana Seber0Leonardo Javier Arcuri1Vergilio Rensi Colturato2Mair Pedro Souza3Yana Augusta Novis Zogbi4Vaneuza Funke5Decio Lerner6Maria Cristina Macedo7Liane Daudt8Mariana Nassif Kerbauy9Victor Gottardello Zecchin10Fernando Barroso Duarte11Ricardo Rabello Chiattone12Rodolfo Daniel de Almeida Soares13Gustavo Bettarello14Antonio Vaz de Macedo15Eduardo Paton16Tatiana Dias Marconi Monteiro17Jayr Schmidt Filho18Claudia Caceres Astigarraga19Phillip Scheinberg20Afonso Celso Vigorito21Carmen Silvia Vieitas Vergueiro22Anderson Simione23Shahrukh Hashmi24Wael Saber25Jinalben Patel26Carmem Maria Sales Bonfim27Marcelo Pasquini28Mary Evelyn Flowers29Nelson Hamerschlak30Bone Marrow Transplant Department, Hospital Samaritano, Sao Paulo, BrazilBone Marrow Transplant Department, Hospital Israelita Albert Einstein, Sao Paulo, BrazilBone Marrow Transplant Department, Hospital Amaral Carvalho, Jau, BrazilBone Marrow Transplant Department, Hospital Amaral Carvalho, Jau, BrazilOncohematology Department, Hospital Sirio-Libanes, Sao Paulo, BrazilBone Marrow Transplant Department, Universidade Federal do Parana, Curitiba, BrazilBone Marrow Transplant Department, Instituto Nacional de Cancer, Rio de Janeiro, BrazilBone Marrow Transplant Team, Bio Sana’s Servicos Medicos, Sao Paulo, BrazilBone Marrow Transplant Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, BrazilBone Marrow Transplant Department, Hospital Israelita Albert Einstein, Sao Paulo, BrazilPediatric Bone Marrow Transplant, Beneficiencia Portuguesa de Sao Paulo, Sao Paulo, Brazil0Hematology, Oncology, and Bone Marrow Transplant Department, Universidade Federal do Ceara, Fortaleza, BrazilBone Marrow Transplant Department, Hospital Samaritano, Sao Paulo, Brazil1Bone Marrow Transplant Department, Universidade Federal do Rio Grande do Norte, Natal, Brazil2Bone Marrow Transplant Department, Hospital DF Star Rede D’or, Brasilia, Brazil3Hematology Department, Hospital da Policia Militar de Minas Gerais, Belo Horizonte, Brazil4Bone Marrow Transplant and Cellular Therapy Unit, Cancer Center Oncoclinicas, Nova Lima, Brazil5Bone Marrow Transplant Unit, Centro de Hematologia de Hemoterapia de Santa Catarina, Florianopolis, Brazil6Hematology, Bone Marrow Transplant, and Cellular Therapy Department, A. C. Camargo Cancer Center, Sao Paulo, BrazilBone Marrow Transplant Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil7Hematology and Oncology Department, Beneficiencia Portuguesa de Sao Paulo, Sao Paulo, Brazil8Hematology, Hemotherapy, and Bone Marrow Transplant Center, Universidade Estadual de Campinas, Campinas, Brazil9Associacao de Medula Ossea do Estado de Sao Paulo, Sao Paulo, BrazilBone Marrow Transplant Department, Hospital Amaral Carvalho, Jau, Brazil0Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States0Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States0Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States1Duke University, Transplant and Cellular Therapy Department, Durham, NC, United States0Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, United States2Fred Hutch Cancer Center, Clinical Research Division, Seattle, WA, United StatesBone Marrow Transplant Department, Hospital Israelita Albert Einstein, Sao Paulo, BrazilIntroductionOver the last decades, the donor network for hematopoietic cell transplantation (HCT) has grown exponentially, including unrelated and haploidentical (Haplo) donors. This study aimed to describe HCT outcomes with MSD, Haplo, and matched unrelated donors (MUD) in an early period of Haplo with posttransplant cyclophosphamide in a developing country with a large unrelated donor registry.MethodsThis study was conducted in collaboration with the CIBMTR. We included patients with acute leukemias undergoing HCT between 2014-2018.ResultsWith 595 patients, 2-year overall survival (OS) was 69% for the MSD, 65% for the Haplo, and 71% for MUD (p=0.24) in CR1, confirmed in multivariable analysis. Relapse rate was lower for MUD (HR=0.35, p=0.0005) than MSD in patients with CR2+, leading to higher OS. Relapse was also higher with Haplo compared with MUD (HR=2.06, p=0.03).DiscussionOnly survival bias can explain these findings in CR2+, suggesting some high-risk MUD patients, in which HCT timing is crucial, may not achieve HCT. Alternative donors were associated with higher non-relapse mortality, while PTCy-based Haplo offered the best protection against chronic graft-versus-host disease. Our study suggests Haplo and MUD are acceptable options for patients lacking MSD in developing countries like ours.https://www.frontiersin.org/articles/10.3389/fonc.2025.1584631/fullhematopoietic cell transplantationsurvival biasacute lymphoblastic leukemiahaploidentical transplantationunrelated donorsmatched-related donors |
| spellingShingle | Adriana Seber Leonardo Javier Arcuri Vergilio Rensi Colturato Mair Pedro Souza Yana Augusta Novis Zogbi Vaneuza Funke Decio Lerner Maria Cristina Macedo Liane Daudt Mariana Nassif Kerbauy Victor Gottardello Zecchin Fernando Barroso Duarte Ricardo Rabello Chiattone Rodolfo Daniel de Almeida Soares Gustavo Bettarello Antonio Vaz de Macedo Eduardo Paton Tatiana Dias Marconi Monteiro Jayr Schmidt Filho Claudia Caceres Astigarraga Phillip Scheinberg Afonso Celso Vigorito Carmen Silvia Vieitas Vergueiro Anderson Simione Shahrukh Hashmi Wael Saber Jinalben Patel Carmem Maria Sales Bonfim Marcelo Pasquini Mary Evelyn Flowers Nelson Hamerschlak Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry Frontiers in Oncology hematopoietic cell transplantation survival bias acute lymphoblastic leukemia haploidentical transplantation unrelated donors matched-related donors |
| title | Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry |
| title_full | Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry |
| title_fullStr | Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry |
| title_full_unstemmed | Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry |
| title_short | Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry |
| title_sort | haploidentical matched related and matched unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry |
| topic | hematopoietic cell transplantation survival bias acute lymphoblastic leukemia haploidentical transplantation unrelated donors matched-related donors |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1584631/full |
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