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Effect of donor age and kinship on outcomes in haplo-identical stem cell transplantation may be modulated by GVHD prophylaxis strategies

Bone Marrow Transplantation volume 56, pages 689–691 (2021)Cite this article

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Donor selection criteria for haplo-identical stem cell transplant (HHCT) have now gained importance as multiple eligible donors are often available for a recipient [1]. We did a single-center retrospective study comprising 63 adults with high-risk hematological malignancies, who underwent T-cell replete HHCT between 2016 and 2018. This study was approved by our institutional Research Ethics Board, and conducted in accordance with the declaration of Helsinki.

We aimed to study the effect of donor variables like age and kinship on HHCT outcomes, when adjusted for patient, disease, and transplant-related factors. Donors were first-degree relatives to whom the patient did not have donor-specific antibodies (DSA). A mean-fluorescence intensity cutoff of 2000 was used to indicate DSA and borderline results were checked using flow cytometric cross match. Reduced intensity conditioning with fludarabine and busulfan, and dual T-cell depletion with PTCy and rabbit ATG as previously published [2], comprised the transplant regimen.

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Fig. 1: Overall survival based on donor age and kinship.

References

  1. Wang Y, Chang YJ, Xu LP, Liu KY, Liu DH, Zhang XH, et al. Who is the best donor for a related HLA haplotype-mismatched transplant? Blood. 2014;124:843–50.

    Article  CAS  Google Scholar 

  2. Law AD, Salas MQ, Lam W, Michelis FV, Thyagu S, Kim DDH, et al. Reduced-intensity conditioning and dual T lymphocyte suppression with antithymocyte globulin and post-transplant cyclophosphamide as graft-versus-host disease prophylaxis in haploidentical hematopoietic stem cell transplants for hematological malignancies. Biol Blood Marrow Transplant. 2018;24:2259–64.

    Article  Google Scholar 

  3. Kollman C, Spellman SR, Zhang MJ, Hassebroek A, Anasetti C, Antin JH, et al. The effect of donor characteristics on survival after unrelated donor transplantation for hematologic malignancy. Blood. 2016;127:260–7.

    Article  CAS  Google Scholar 

  4. Jaiswal S, Fontanillas P, Flannick J, Manning A, Grauman PV, Mar BG, et al. Age-related clonal hematopoiesis associated with adverse outcomes. N Eng J Med. 2014;371:2488–98.

    Article  Google Scholar 

  5. Zhang C, Chen XH, Zhang X, Gao L, Gao L, Kong PY, et al. Stem cell collection in unmanipulated HLA-haploidentical/mismatched related transplantation with combined granulocyte-colony stimulating factor-mobilised blood and bone marrow for patients with haematologic malignancies: the impact of donor characteristics and procedural settings. Transfus Med. 2010;20:169–77.

    Article  CAS  Google Scholar 

  6. Solomon SR, Aubrey MT, Zhang X, Piluso A, Freed BM, Brown S, et al. Selecting the best donor for haploidentical transplant: impact of HLA, killer cell immunoglobulin-like receptor genotyping, and other clinical variables. Biol Blood Marrow Transplant. 2018;24:789–98.

    Article  CAS  Google Scholar 

  7. McCurdy SR, Zhang MJ, St Martin A, Al Malki MM, Bashey A, Gaballa S, et al. Effect of donor characteristics on haploidentical transplantation with post-transplantation cyclophosphamide. Blood Adv. 2018;2:299–307.

    Article  Google Scholar 

  8. Canaani J, Savani BN, Labopin M, Huang XJ, Ciceri F, Arcese W, et al. Donor age determines outcome in acute leukemia patients over 40 undergoing haploidentical hematopoietic cell transplantation. Am J Hematol. 2018;93:246–53.

    Article  Google Scholar 

  9. Finke J, Schmoor C, Bethge WA, Ottinger HD, Stelljes M, Zander AR, et al. Prognostic factors affecting outcome after allogeneic transplantation for hematological malignancies from unrelated donors: results from a randomized trial. Biol Blood Marrow Transplant. 2012;18:1716–26.

    Article  Google Scholar 

  10. Gurman G, Ataca P, Atilla E, Bozdag SC, Toprak SK, Yuksel MK, et al. Positive impact of chronic graft-versus host disease on survival in 928 allogeneic hematopoietic stem cell transplant recipients. Blood. 2015;126:1952.

    Article  Google Scholar 

  11. Fuchs EJ. HLA-haploidentical blood or marrow transplantation with high-dose, post-transplantation cyclophosphamide. Bone Marrow Transplant. 2015;50:S31–6.

    Article  CAS  Google Scholar 

  12. Stern M, Ruggeri L, Mancusi A, Bernardo ME, de Angelis C, Bucher C, et al. Survival after T cell-depleted haploidentical stem cell transplantation is improved using the mother as donor. Blood. 2008;112:2990–5.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Section of Medical Oncology and Hematology, University of Toronto, Toronto, ON, Canada

    Shruti Prem, Maria Queralt Salas, Zeyad Al-Shaibani, Wilson Lam, Arjun Datt Law, Dennis (Dong Hwan) Kim, Fotios V. Michelis, Jeffrey Howard Lipton, Jonas Mattsson, Rajat Kumar & Auro Viswabandya

  2. Hans Messner Allogeneic Blood and Marrow Transplantation Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada

    Shruti Prem, Maria Queralt Salas, Zeyad Al-Shaibani, Wilson Lam, Arjun Datt Law, Dennis (Dong Hwan) Kim, Fotios V. Michelis, Jeffrey Howard Lipton, Jonas Mattsson, Rajat Kumar & Auro Viswabandya

  3. Department of Medical Sciences, Uppsala University and KFUE, Uppsala University Hospital, Uppsala, Sweden

    Mats Remberger

  4. HLA Laboratory, Lab Medicine Program, University Health Network, Toronto, ON, Canada

    Cynthia Ellison

  5. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada

    Cynthia Ellison

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  1. Shruti Prem
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Contributions

SP and MQS collected the data, SP and MR analyzed the data and wrote the paper, CE, RK, AV, and MR provided valuable input into the study design, analysis, and interpretation and reviewed the paper, ZA, WL, AL, JM, JL, FM, and DK, provided valuable input into the interpretation of results and reviewed the paper.

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Correspondence to Auro Viswabandya.

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The authors declare that they have no conflict of interest.

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Prem, S., Remberger, M., Salas, M.Q. et al. Effect of donor age and kinship on outcomes in haplo-identical stem cell transplantation may be modulated by GVHD prophylaxis strategies. Bone Marrow Transplant 56, 689–691 (2021). https://doi.org/10.1038/s41409-020-01030-x

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