Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation

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.

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Publication Details

Journal
Blood Advances
Published
2025-03-14
DOI
https://doi.org/10.1182/bloodadvances.2024014938
Citations
5
Primary Topic
Hematopoietic Stem Cell Transplantation
Type
article
Field-Weighted Citation Impact
8.85
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article

Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation

Masatsugu Tanaka, Naoyuki Uchida, Fumiya Wada, Mamiko Sakata‐Yanagimoto et al.
5 citations
Blood Advances
Hematopoietic Stem Cell Transplantation
8.85
article

Impact of haplo-donor age on transplant outcomes: a comparative analysis of haploidentical vs cord blood transplantation

Masatsugu Tanaka, Naoyuki Uchida, Fumiya Wada, Mamiko Sakata‐Yanagimoto, Yuta Hasegawa, Takashi Nagayama, Noriko Doki, Tetsuya Nishida, Satoshi Nishiwaki, Yoshiko Atsuta, Fumihiko Ishimaru, Hideki Nakasone, Toshiro Kawakita, Shuichi Ota, Makoto Onizuka, Hirohisa Nakamae, Masahito Tokunaga, Masashi Sawa, Yoshinobu Kanda, Shin-ichiro Fujiwara, Kazuya Ishiwata, Takahiro Fukuda
article en
5 citations

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.

Blood AdvancesVol. 9(13)
Tokai University (JP), University of Tsukuba (JP), Jichi Medical University (JP), Aichi Medical University (JP), Kyoto University (JP), Japanese Red Cross Society, Japan (JP), Kanagawa Prefectural Hospital Organization (JP), Tokyo Metropolitan Komagome Hospital (JP), Kurashiki Central Hospital (JP), Nagoya University Hospital (JP), Sapporo Hokuyu Hospital (JP), University of Tsukuba Hospital (JP), Imamura Hospital (JP), Japanese Red Cross Nagoya Daiichi Hospital (JP), Hokkaido University Hospital (JP), Anjo Kosei Hospital (JP), Jichi Medical University Hospital (JP), Osaka University Hospital (JP), The Japanese Data Center for Hematopoietic Cell Transplantation (JP), Tokyo National Hospital (JP), Kumamoto Medical Center (JP), Jichi Medical University Saitama Medical Center (JP), Toranomon Hospital (JP), Kanagawa Cancer Center, Osaka Metropolitan University (JP), Tokyo Metropolitan University (JP)
Good health and well-being
Openalex Percentile: Top 3%
Hematopoietic Stem Cell Transplantation
8.85
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