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Impact of second-degree related donor on the outcomes of T cell-replete haploidentical transplantation with post-transplant cyclophosphamide

Bone Marrow Transplantation volume 57, pages 1758–1764 (2022)Cite this article

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Abstract

Donor selection may contribute to improve clinical outcomes of T cell-replete haploidentical stem cell transplantation (Haplo-SCT) with post-transplant cyclophosphamide (PT-Cy). Impact of second-degree related donor (SRD) was not fully elucidated in this platform. We retrospectively compared the outcome of patients receiving Haplo-SCT either from a SRD (n = 31) or a first-degree related donor (FRD, n = 957). Median time to neutrophil and platelet recovery did not differ between a SRD and a FRD transplant (p = 0.599 and 0.587). Cumulative incidence of grade II–IV acute graft-versus host disease (GVHD) and moderate-severe chronic GVHD was 13% and 19% after SRD vs 24% (p = 0.126) and 13% (p = 0.395) after FRD transplant. One-year cumulative incidence of non-relapse mortality (NRM) was 19% for SRD and 20% for FRD (p = 0.435) cohort. The 3-year probability of overall survival (OS) and progression-free survival (PFS) was 42% vs 55% (p = 0.273) and 49% vs 35% (p = 0.280) after SRD and FRD transplant, respectively. After propensity score adjustment or matched pair analysis, the outcome of patients receiving Haplo-SCT from a SRD or a FRD did not differ in terms of NRM, OS, PFS, acute and chronic GVHD. Our results suggest that a SRD is a viable option for Haplo-SCT with PT-Cy when a FRD is not available.

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Fig. 1: Engraftment and GVHD rate.
Fig. 2: Infections after first degree and second-degree related donot tranplant.
Fig. 3: Outcomr of patients receiving first-degree or second-degree related donor transplant.

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Acknowledgements

This work was supported by the following funding: Fondazione Cariplo 2015/0603 (DM and BB) Associazione Italiana per la Ricerca sul Cancro IG21567, and Intramural Research Funding of Istituto Clinico Humanitas (5*1000 project) (DM and LC).

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Author notes

  1. These authors contributed equally: Jacopo Mariotti, Anna Maria Raiola.

  2. These authors jointly supervised this work: Domenico Mavilio, Emanuele Angelucci, Luca Castagna.

Authors and Affiliations

  1. Bone Marrow Transplant Unit, Humanitas Clinical and Research Center – IRCCS, Humanitas Cancer Center, via Manzoni 56, 20089, Rozzano, Milan, Italy

    Jacopo Mariotti, Stefania Bramanti & Luca Castagna

  2. Hematology and Bone Marrow Transplant Unit, Ospedale Policlinico San Martino, Genoa, Italy

    Anna Maria Raiola & Emanuele Angelucci

  3. Unit of Clinical Epidemiology, Città della Salute e della Scienza di Torino, Torino, Italy

    Andrea Evangelista

  4. Department of Hematology, Transplantation Program, Institut Paoli-Calmettes, Marseille, France

    Samia Harbi, Christian Chabannon, Sabine Furst & Raynier Devillier

  5. Hematology and Transplant Center Unit, Udine University Hospital, DAME, University of Udine, 33100, Udine, Italy

    Francesca Patriarca, Renato Fanin & Alessandra Sperotto

  6. Department of Oncology and Hematology Bone Marrow Transplant Unit Fondazione Casa Sollievo della Sofferenza San Giovanni Rotondo, Torino, Italy

    Michele Angelo Carella, Emanuela Merla & Lucia Savino

  7. Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy

    Massimo Martino, Barbara Loteta & Giuseppe Console

  8. Department of Clinical Medicine and Surgery, Bone Marrow Transplant Center, Federico II University of Naples, Naples, Italy

    Antonio Risitano, Luana Marano, Serena Marotta & Camilla Frieri

  9. Department of Oncology/Hematology, A.O.U. Città della Salute e della Scienza di Torino, Presidio Molinette, Torino, Italy

    Alessandro Busca, Luisa Giaccone, Lucia Brunello & Benedetto Bruno

  10. Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy

    Luisa Giaccone

  11. Istituto di Ematologia, Fondazione Policlinico Universitario A.Gemelli, Universita’ Cattolica, Roma, Italy

    Simona Sica, Patrizia Chiusolo & Andrea Bacigalupo

  12. Department of Oncology/Hematology, Humanitas Clinical and Research Center, Rozzano, Italy

    Armando Santoro

  13. Department of Hematology, Transplantation Program, Aix-Marseille Univ, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France

    Didier Blaise

  14. Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Rozzano-Milan, Italy

    Domenico Mavilio

  15. Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy

    Domenico Mavilio

Authors
  1. Jacopo Mariotti
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Contributions

JM performed research, analyzed and interpreted data, wrote the paper; AMR collected data and provided data interpretation; AE provided data analysis and interpretation; MAC, MM, FP, AR collected data and supervised the paper; AB, LG, LB, BL, GC, RF, AS, LM, SM, CF, SS, PC collected data; AB, DB, provided data interpretation and revised the paper; SB designed research; DM, EA, LC, and BB designed research, provided data interpretation, and supervised paper writing.

Corresponding author

Correspondence to Stefania Bramanti.

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Mariotti, J., Raiola, A.M., Evangelista, A. et al. Impact of second-degree related donor on the outcomes of T cell-replete haploidentical transplantation with post-transplant cyclophosphamide. Bone Marrow Transplant 57, 1758–1764 (2022). https://doi.org/10.1038/s41409-022-01565-1

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