Johannes Schetelig, Henning Baldauf, Carina Rave, Gesine Bug, Lutz P. Müller, Eva Maria Wagner-Drouet, Francis Ayuketang Ayuk, Wolfgang Bethge, Matthias Stelljes, Thomas Schroeder, Friedrich Stölzel, Edgar Jost, Christoph Schmid, Desiree Kunadt, Katja Sockel, Katharina Egger-Heidrich, Jan Moritz Middeke, Daniel Fürst, Daniel Schefzyk, Jürgen Sauter, Alexander H. Schmidt, Katharina Fleischhauer, Martin Bornhäuser, on behalf of the German Cooperative Transplant Study Group, Deutsches Register für hämatopoetische Stammzelltransplantation und Zelltherapie (DRST)
{"title":"Young unrelated donors confer a survival advantage for patients with myeloid malignancies compared to older siblings","authors":"Johannes Schetelig, Henning Baldauf, Carina Rave, Gesine Bug, Lutz P. Müller, Eva Maria Wagner-Drouet, Francis Ayuketang Ayuk, Wolfgang Bethge, Matthias Stelljes, Thomas Schroeder, Friedrich Stölzel, Edgar Jost, Christoph Schmid, Desiree Kunadt, Katja Sockel, Katharina Egger-Heidrich, Jan Moritz Middeke, Daniel Fürst, Daniel Schefzyk, Jürgen Sauter, Alexander H. Schmidt, Katharina Fleischhauer, Martin Bornhäuser, on behalf of the German Cooperative Transplant Study Group, Deutsches Register für hämatopoetische Stammzelltransplantation und Zelltherapie (DRST)","doi":"10.1038/s41375-025-02724-1","DOIUrl":null,"url":null,"abstract":"Donor age is one factor to optimize allogeneic hematopoietic cell transplantation (alloHCT). Therefore, we investigated whether young unrelated donors (UD) provide a benefit for older patients with myeloid malignancies compared to HLA-identical sibling donors (MSD). We performed a retrospective registry study on patients ≥50 years who received a first alloHCT between 2010 and 2020. We compared event-free survival (EFS) of patients who were transplanted from MSD aged ≥50 years versus UD aged ≤35 years who were HLA-compatible for HLA-A, -B, -C, and -DRB1. In total, we analyzed data from 3460 patients. With multivariable adjustment EFS (HR 0.86, p = 0.003), OS (HR 0.82, p < 0.001), and risk of relapse (HR 0.84, p = 0.018) were significantly better for HLA-compatible UD compared to MSD. No survival advantage was found, when UD with unfavorable sex or CMV constellation were compared to MSD with favorable constellations. In a meta-analysis on 9905 patients with myeloid malignancies, including ours, we found reduced risk of relapse (pooled HR 0.78, p = 0.006) and better EFS (pooled HR 0.89, p < 0.001) for young matched UD versus MSD. To select young HLA-compatible UD over older MSD may reduce relapse risk and improve survival for older patients with myeloid malignancies.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 10","pages":"2523-2532"},"PeriodicalIF":13.4000,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02724-1.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Leukemia","FirstCategoryId":"3","ListUrlMain":"https://www.nature.com/articles/s41375-025-02724-1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Donor age is one factor to optimize allogeneic hematopoietic cell transplantation (alloHCT). Therefore, we investigated whether young unrelated donors (UD) provide a benefit for older patients with myeloid malignancies compared to HLA-identical sibling donors (MSD). We performed a retrospective registry study on patients ≥50 years who received a first alloHCT between 2010 and 2020. We compared event-free survival (EFS) of patients who were transplanted from MSD aged ≥50 years versus UD aged ≤35 years who were HLA-compatible for HLA-A, -B, -C, and -DRB1. In total, we analyzed data from 3460 patients. With multivariable adjustment EFS (HR 0.86, p = 0.003), OS (HR 0.82, p < 0.001), and risk of relapse (HR 0.84, p = 0.018) were significantly better for HLA-compatible UD compared to MSD. No survival advantage was found, when UD with unfavorable sex or CMV constellation were compared to MSD with favorable constellations. In a meta-analysis on 9905 patients with myeloid malignancies, including ours, we found reduced risk of relapse (pooled HR 0.78, p = 0.006) and better EFS (pooled HR 0.89, p < 0.001) for young matched UD versus MSD. To select young HLA-compatible UD over older MSD may reduce relapse risk and improve survival for older patients with myeloid malignancies.
期刊介绍:
Title: Leukemia
Journal Overview:
Publishes high-quality, peer-reviewed research
Covers all aspects of research and treatment of leukemia and allied diseases
Includes studies of normal hemopoiesis due to comparative relevance
Topics of Interest:
Oncogenes
Growth factors
Stem cells
Leukemia genomics
Cell cycle
Signal transduction
Molecular targets for therapy
And more
Content Types:
Original research articles
Reviews
Letters
Correspondence
Comments elaborating on significant advances and covering topical issues