Donor's age influences outcome in haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide - a single center experience.

Autor: Zielińska P; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland. pzielinska@sum.edu.pl., Wieczorkiewicz-Kabut A; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland., Białas K; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland., Koclęga A; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland., Gruenpeter K; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland., Kopińska A; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland., Woźniczka K; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland., Noster I; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland., Gromek T; Department of Hematooncology and Bone Marrow Transplantation, Medical Univeristy of Lublin, Lublin, Poland., Czyż J; Department of Hematology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland., Grosicki S; Department of Hematology and Cancer Prevention, Chorzów, Faculty of Public Health in Bytom, Medical University in Katowice, Chorzów, Poland., Wierzbowska A; Department of Hematology, Medical University of Lodz, Łódź, Poland., Krzanowski J; Brzozow Oncology Center, Brzozów, Poland., Butrym A; Department of Cancer Prevention and Therapy, Wroclaw Medical University, Wałbrzych, Poland., Helbig G; Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Dąbrowski Street 25, Katowice, Poland.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2024 Aug; Vol. 103 (8), pp. 3095-3104. Date of Electronic Publication: 2024 Jun 15.
DOI: 10.1007/s00277-024-05848-z
Abstrakt: Haploidentical stem cell transplantation (haplo-SCT) using post-transplantation cyclophosphamide (post-Cy) is considered a reasonable therapeutic option for patients who lack matched donor or who urgently need transplant procedure due to high risk disease. We analyzed the results of haplo-SCT performed in years 2018-2023. Eighty one patients (46 males) at median age of 52 years underwent haplo-SCT using peripheral blood as a stem cell source in most cases. Indications included hematological malignancies (acute leukemias in 88% of cases). In 25 cases (31%) transplantation was performed in relapsed/refractory disease. Majority of patients (61%) presented with very high and high disease risk index (DRI). Conditioning regimens were as follows: nonmyeloablative - 46 cases (57%), myeloablative - in 18 (22%) and reduced intensity - 17(20%). 90% of patients engrafted. All patients received unified immunosuppressive treatment (post-Cy/TAC/MMF). Median follow-up time was 12 months The cumulative incidence of acute and chronic GVHD was 37.5% and 37.6%, respectively. Estimated 2-year overall survival (OS) was 43.1% and donor's age was the only factor influencing survival. The 2-year progression-free survival (PFS) was 42.5%, whereas relapse incidence (RI) - 35%. The cumulative incidence of non-relapse mortality (NRM) was 44% and was mostly due to infections. Haplo-SCT is a feasible treatment option for hematological patients. Younger donor improves post-transplant survival. Strategies to reduce infection-related mortality and relapse rate remain a challenge.
(© 2024. The Author(s).)
Databáze: MEDLINE
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