Impact of Donor Type on Outcomes After Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis: A Study on Behalf of the Chronic Malignancies Working Party of the <scp>EBMT</scp>
Selecting the optimal donor is crucial for optimizing results of allogeneic hematopoietic cell transplantation (allo-HCT). We analyzed outcomes based on donor type in 2809 myelofibrosis (MF) patients undergoing first allo-HCT between 2015 and 2021 at EBMT centers. Study outcomes included overall survival (OS), progression-free survival (PFS), relapse, non-relapse mortality (NRM), engraftment, and graft-versus-host disease (GvHD). Four groups were compared: matched sibling donor (MSD, n = 742), matched unrelated donor (MUD, n = 1401), mismatched unrelated donor (MMUD, n = 379) and haploidentical donor (HD, n = 287). After a median follow-up of 33.5 months, 3-year OS rates were 65.8%, 61.5%, 53.2%, and 57.7% for MSD, MUD, MMUD, and HD, respectively. Multivariable analyses (MSD as reference) showed that donor type significantly correlated with OS (HR: 1.63 for MMUD, HR: 1.42 for HD), PFS (HR: 1.38 for MMUD), NRM (HR: 1.73 for MMUD, HR: 1.47 for HD), engraftment (HR: 0.72 for MMUD, HR: 0.40 for HD), grade 2-4 acute GvHD (HR: 1.53 for MUD, HR: 1.69 for MMUD, HR: 1.49 for HD), and extensive chronic GvHD (HR: 0.77 for MUD, HR: 0.65 for HD). Donor type was not associated with relapse risk. In patients over 60 years, correlations between donor type and outcomes were consistent with those in the overall study population. In summary, with current practices, MF patients receiving MSD or MUD grafts achieve comparable outcomes. In contrast, MMUD and HD transplants have worse OS due to increased NRM. MMUD transplants have a higher risk of GvHD than HD transplants, but this difference seems to disappear with post-transplant cyclophosphamide.
Authors
- Kavita K Raj (ORCID: https://orcid.org/0000-0002-8258-354X)
- Jakob Robert Passweg (ORCID: https://orcid.org/0000-0001-7092-3351)
- Tomasz Czerw (ORCID: https://orcid.org/0000-0003-3108-4035)
- Nicola Polverelli (ORCID: https://orcid.org/0000-0001-6297-9697)
- Marie Robin (ORCID: https://orcid.org/0000-0003-1388-9876)
- Donal P. McLornan (ORCID: https://orcid.org/0000-0003-1224-091X)
- Didier Blaise (ORCID: https://orcid.org/0000-0002-5684-9447)
- Giorgia Battipaglia (ORCID: https://orcid.org/0000-0002-0695-3879)
- Andrew Clark (ORCID: https://orcid.org/0000-0003-4666-5991)
- Henrik Sengeløv (ORCID: https://orcid.org/0000-0002-5991-2958)
- Patrizia Chiusolo (ORCID: https://orcid.org/0000-0002-1355-1587)
- Ibrahim Yakoub‐Agha (ORCID: https://orcid.org/0000-0003-4524-8782)
- Massimiliano Gambella (ORCID: https://orcid.org/0000-0002-7896-4198)
- Joanna Ewa Drozd-Sokolowska (ORCID: https://orcid.org/0000-0002-4562-6264)
- Piero Galieni (ORCID: https://orcid.org/0000-0002-0793-264X)
- Juan Carlos Hernández‐Boluda (ORCID: https://orcid.org/0000-0002-4289-3113)
- Robert Zeiser (ORCID: https://orcid.org/0000-0001-6565-3393)
- M. Stelljes
- Vipul Sheth (ORCID: https://orcid.org/0000-0002-7087-5422)
- Simona Iacobelli
- Urpu Salmenniemi (ORCID: https://orcid.org/0000-0002-6572-5470)
- Thomas Schroeder
- Linda Köster
- Nicolaus Kröger
- Werner Rabisch
Institutions
- Università Cattolica del Sacro Cuore (IT)
- University College London Hospitals NHS Foundation Trust (GB)
- Inserm (FR)
- Universität Hamburg (DE)
- University of Freiburg (DE)
- University of Münster (DE)
- Université de Lille (FR)
- Medical University of Warsaw (PL)
- Glasgow Royal Infirmary (GB)
- University Hospital of Basel (CH)
- Agostino Gemelli University Polyclinic (IT)
- Rigshospitalet (DK)
- Centre Hospitalier Universitaire de Lille (FR)
- Düsseldorf University Hospital (DE)
- Rajiv Gandhi Cancer Institute and Research Centre (IN)
- Hospital Clínico Universitario de Valencia (ES)
- European Society for Blood and Marrow Transplantation (NL)
- University Medical Center Hamburg-Eppendorf (DE)
- Federico II University Hospital (IT)
- Essen University Hospital (DE)
- Nini Hospital (LB)
- Central Clinical Hospital (PL)
- Hôpital Saint-Louis (FR)
- Ospedale Policlinico San Martino (IT)
- The Maria Sklodowska-Curie National Research Institute of Oncology (PL)
- Policlinico San Matteo Fondazione (IT)
- Universitätszahnklinik Wien (AT)
- Department of Public Health (MM)
- Heinrich Heine University Düsseldorf (DE)
- University College London (GB)
- University of Naples Federico II (IT)
- Sapienza University of Rome (IT)
Publication Details
- Journal
- American Journal of Hematology
- Published
- 2025-08-29
- DOI
- https://doi.org/10.1002/ajh.70049
- Primary Topic
- Myeloproliferative Neoplasms: Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00