| Popis: |
when using post-transplant cyclophosphamide (PTCy) graft-versus-host-disease (GVHD) prophylaxis for lymphoma patients, it is currently unknown whether a matched unrelated donor (MUD) or a haploidentical related donor is preferable if both are available.In this study we wanted to test if using a haploidentical donor has the same results of a MUD.a total of 2140 adults (34% CIBMTR, 66% EBMT registry) aged ≥18 years who received their first haploidentical hematopoietic cell transplant (haplo-HCT) or MUD-HCT (8/8 match at HLA-loci A, B, C, and DRB1) for lymphoma using PTCy-based GVHD prophylaxis from 2010-2019 were retrospectively analyzed.The majority of both MUD and haploidentical HCTs received reduced intensity/non-myeloablative conditioning (74% and 77%, respectively), used a peripheral blood stem cell graft (91% and 60%, respectively) and a three-drug GVHD prophylaxis (PTCy + calcineurin inhibitor + MMF in 54% and 90%, respectively). Haploidentical HCT has less favorable results versus MUD cohort in terms of overall mortality (HR=1.69, 95%CI=1.30-2.27, p0.001), progression-free survival (HR=1.39, 95%CI=1.10 - 1.79, p=0.008), non-relapse mortality (HR=1.93, 95% CI=1.21 - 3.07, p=0.006), platelets engraftment (HR=0.69, 95%CI=0.59 - 0.80, p0.001), acute grade 2-4 GVHD incidence (HR=1.65, 95%CI=1.28 - 2.14, p0.001) and chronic GVHD (HR=1.79, 95%CI=1.30 - 2.48, p0.001). No significant differences were observed in terms of relapse and neutrophil engraftment. Adjusting for propensity score yielded similar results.whenever MUD is available in a timely manner, it should be preferred over a haploidentical donor when using PTCy-based GVHD prophylaxis for patients with lymphoma. |
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