Outcomes of haploidentical transplants with PT-CY vs 10/10 MUD transplants with ATG in Germany

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the best curative treatment modality for many malignant hematologic disorders. In the absence of a matched related donor, matched unrelated donors (MUDs) and haploidentical donors are the most important stem cell sources. In this registry-based retrospective study, we compared the outcomes of allo-HSCTs from 10/10 MUDs with antithymocyte globulin (ATG)-based regimens (n = 7050) vs haploidentical transplants (Haplo-Tx) using posttransplant cyclophosphamide (PT-CY Haplo; n = 487) in adult patients with hematologic malignancies between 2010 and 2020. Cox proportional hazard-and competing risks regression models were formed to compare the outcomes. Overall survival (OS), Disease-free survival (DFS), and graft-versus-host disease (GVHD)-free and relapse-free survival (GRFS) were superior for 10/10 MUDs (OS [hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.10-1.47; P = .001]; DFS [HR, 1.17; CI, 1.02-1.34; P = .022]; GRFS [HR, 1.34; CI, 1.19-1.50; P < .001]). The risk of acute GVHD (aGVHD) grade 2 to 4, aGVHD grade 3 to 4, and chronic GVHD (cGVHD) was higher in the PT-CY Haplo group than the 10/10 MUD group (aGVHD grade 2-4 [HR, 1.46; CI, 1.25-1.71; P < .001]; aGVHD grade 3-4 [HR, 1.74; CI, 1.37- 2.20; P < .001]; cGVHD [HR, 1.30; CI, 1.11-1.51; P = .001]). A lower incidence of relapse was observed in the PT-CY Haplo group (relapse: HR, 0.83; CI, 0.69-0.99; P = .038). Unrelated 10/10 matched transplantation with ATG leads to lower GVHD rates and improved survival rates compared with PT-CY Haplo transplantation in Germany.

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Publication Details

Journal
Blood Advances
Published
2024-10-05
DOI
https://doi.org/10.1182/bloodadvances.2024013719
Citations
2
Primary Topic
Hematopoietic Stem Cell Transplantation
Type
article
Field-Weighted Citation Impact
0.91

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article

Outcomes of haploidentical transplants with PT-CY vs 10/10 MUD transplants with ATG in Germany

Nicolaus Martin Kröger, Johannes Schetelig, Matthias Stelljes, Joannis Mytilineos et al.
2 citations
Blood Advances
Hematopoietic Stem Cell Transplantation
0.91
article

Outcomes of haploidentical transplants with PT-CY vs 10/10 MUD transplants with ATG in Germany

Nicolaus Martin Kröger, Johannes Schetelig, Matthias Stelljes, Joannis Mytilineos, Elisa Maria Amann, Mark Ringhoffer, Wolfgang Andreas Bethge, Thomas Schröder, Sandra Schmeller, Ayşenur Arslan, Hubert Schrezenmeier, Christine Neuchel, Elisa Sala, Matthias Edinger, Daniel Teschner, Robert Zeiser, Peter Dreger, Gesine Bug, Jan Beyersmann, Amelie Schmid‐Möglich, Daniel E Furst, Matthias Eder, Georg‐Nikolaus Franke, Svenja Labuhn
article en
2 citations

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the best curative treatment modality for many malignant hematologic disorders. In the absence of a matched related donor, matched unrelated donors (MUDs) and haploidentical donors are the most important stem cell sources. In this registry-based retrospective study, we compared the outcomes of allo-HSCTs from 10/10 MUDs with antithymocyte globulin (ATG)-based regimens (n = 7050) vs haploidentical transplants (Haplo-Tx) using posttransplant cyclophosphamide (PT-CY Haplo; n = 487) in adult patients with hematologic malignancies between 2010 and 2020. Cox proportional hazard-and competing risks regression models were formed to compare the outcomes. Overall survival (OS), Disease-free survival (DFS), and graft-versus-host disease (GVHD)-free and relapse-free survival (GRFS) were superior for 10/10 MUDs (OS [hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.10-1.47; P = .001]; DFS [HR, 1.17; CI, 1.02-1.34; P = .022]; GRFS [HR, 1.34; CI, 1.19-1.50; P < .001]). The risk of acute GVHD (aGVHD) grade 2 to 4, aGVHD grade 3 to 4, and chronic GVHD (cGVHD) was higher in the PT-CY Haplo group than the 10/10 MUD group (aGVHD grade 2-4 [HR, 1.46; CI, 1.25-1.71; P < .001]; aGVHD grade 3-4 [HR, 1.74; CI, 1.37- 2.20; P < .001]; cGVHD [HR, 1.30; CI, 1.11-1.51; P = .001]). A lower incidence of relapse was observed in the PT-CY Haplo group (relapse: HR, 0.83; CI, 0.69-0.99; P = .038). Unrelated 10/10 matched transplantation with ATG leads to lower GVHD rates and improved survival rates compared with PT-CY Haplo transplantation in Germany.

Blood AdvancesVol. 8(23)
Goethe University Frankfurt (DE), Universität Hamburg (DE), Universität Ulm (DE), Heidelberg University (DE), University Medical Center Freiburg (DE), German Red Cross (DE), University Hospital Heidelberg (DE), University Hospital Regensburg (DE), Medizinische Hochschule Hannover (DE), Städtisches Klinikum Karlsruhe (DE), University Hospital Münster (DE), University Medical Center Hamburg-Eppendorf (DE), Essen University Hospital (DE), Universitätsklinikum Würzburg (DE), German National Bone Marrow Donor Registry (DE), University Hospital Ulm (DE), University Hospital Carl Gustav Carus (DE), Klinik und Poliklinik für Augenheilkunde am Universitätsklinikum Carl Gustav Carus (DE), Deutsche Knochenmarkspenderdatei (DE), Klinik und Poliklinik für Psychotherapie und Psychosomatik (DE), Leibniz Institute for Immunotherapy, University of Regensburg (DE), Technische Universität Dresden (DE), University of Tübingen (DE), Leipzig University (DE)
Deutsche Forschungsgemeinschaft
Openalex Percentile: Top 22%
Hematopoietic Stem Cell Transplantation
0.91
DOIOpen Access PDFOpenAlex
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