Donor age as an independent predictor of inferior outcomes after haploidentical hematopoietic cell transplantation in acute myeloid leukemia. Study conducted on behalf of GETH-TC

This study evaluated the impact of donor age on clinical outcomes in 274 patients with acute myeloid leukemia (AML) haplo-HCT using PTCY-based prophylaxis. Median patient age was 53 years, with 42.6% classified as high-risk AML. The median donor age of 38 years; 31% were under 30. An optimal donor age cut-off of 30 years was identified through ROC analysis. Patients receiving grafts from younger donors (<30 years) showed lower rates of aGVHD grade II-IV (3.0% vs. 19.9%, p < 0.001) and grade III-IV (1.5% vs. 10.2%, p = 0.034), with no differences in cGVHD or relapse rates. Overall survival (OS) was higher in the younger donor group (2-year: 80.6% vs. 64.3%, p = 0.011), along by lower non-relapse mortality (NRM) (2-year: 11.1% vs. 23.2%, p = 0.031). Multivariate analysis confirmed donor age ≥30 years as an independent adverse factor for OS (HR: 1.88, p = 0.019) and NRM (HR: 2.06, p = 0.049), along with older recipient age, higher HCT-CI score, and high-risk AML. These findings suggest that younger donor age contributes to improved survival, primarily through reduced NRM and aGVHD, supporting prioritization of younger donors when multiple haploidentical options are available to optimize transplant outcomes.

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Publication Details

Journal
Frontiers in Immunology
Published
2025-11-28
DOI
https://doi.org/10.3389/fimmu.2025.1700463
Primary Topic
Hematopoietic Stem Cell Transplantation
Type
article
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article

Donor age as an independent predictor of inferior outcomes after haploidentical hematopoietic cell transplantation in acute myeloid leukemia. Study conducted on behalf of GETH-TC

Inmaculada Heras Fernando, Lucía García, Sara Villar, Albert Esquirol et al.
Frontiers in Immunology
Hematopoietic Stem Cell Transplantation
article

Donor age as an independent predictor of inferior outcomes after haploidentical hematopoietic cell transplantation in acute myeloid leukemia. Study conducted on behalf of GETH-TC

Inmaculada Heras Fernando, Lucía García, Sara Villar, Albert Esquirol, María Queralt Salas, Cynthia Acosta Fleitas, Tamara Torrado, Clara Aparicio, Sara Fernández‐Luis, José Luis López Lorenzo, Ana Pilar González, Estefanía Pérez López, Carmen Martín, Marta Luque, Adolfo Sáez, Carlos Martín‐Rodríguez, Juan José Domínguez-García, Felipe Peña-Muñóz, Pascual Balsalobre, Daniel Munárriz, Silvia Filaferro, Itziar Oiartzabal Ormtegi, Montserrat Rovira, María Jesús Pascual Cascón
article en

Abstract

This study evaluated the impact of donor age on clinical outcomes in 274 patients with acute myeloid leukemia (AML) haplo-HCT using PTCY-based prophylaxis. Median patient age was 53 years, with 42.6% classified as high-risk AML. The median donor age of 38 years; 31% were under 30. An optimal donor age cut-off of 30 years was identified through ROC analysis. Patients receiving grafts from younger donors (<30 years) showed lower rates of aGVHD grade II-IV (3.0% vs. 19.9%, p < 0.001) and grade III-IV (1.5% vs. 10.2%, p = 0.034), with no differences in cGVHD or relapse rates. Overall survival (OS) was higher in the younger donor group (2-year: 80.6% vs. 64.3%, p = 0.011), along by lower non-relapse mortality (NRM) (2-year: 11.1% vs. 23.2%, p = 0.031). Multivariate analysis confirmed donor age ≥30 years as an independent adverse factor for OS (HR: 1.88, p = 0.019) and NRM (HR: 2.06, p = 0.049), along with older recipient age, higher HCT-CI score, and high-risk AML. These findings suggest that younger donor age contributes to improved survival, primarily through reduced NRM and aGVHD, supporting prioritization of younger donors when multiple haploidentical options are available to optimize transplant outcomes.

Frontiers in ImmunologyVol. 16
Hospital de Sant Pau (ES), Hospital General Universitario Morales Meseguer (ES), Hospital Universitario de Gran Canaria Doctor Negrín (ES), Complejo Hospitalario de Salamanca (ES), Marqués de Valdecilla University Hospital (ES), Hospital Universitario 12 De Octubre (ES), Institut Català d'Oncologia (ES), Hospital Regional Universitario de Málaga (ES), Fundación Marques de Valdecilla (ES), Instituto de Investigación Marqués de Valdecilla (ES), Hospital Clínic de Barcelona (ES), Hospital Universitario Reina Sofía (ES), Hospital Universitario Fundación Jiménez Díaz (ES), Hospital Universitario Central de Asturias (ES), Instituto de Investigación Biomédica de Salamanca (ES), Clinica Universidad de Navarra (ES), Donostiako Unibertsitate Ospitalea (ES), Complexo Hospitalario Universitario A Coruña (ES), Duran i Reynals Hospital (ES), Hospital Universitario Son Espases (ES)
Openalex Percentile: Top 51%
Hematopoietic Stem Cell Transplantation
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