Faculty Collaboration Database

Effect of donor characteristics on haploidentical transplantation with posttransplantation cyclophosphamide. Blood Adv 2018 Feb 13;2(3):299-307

Date

02/15/2018

Pubmed ID

29440002

Pubmed Central ID

PMC5812334

DOI

10.1182/bloodadvances.2017014829

Scopus ID

2-s2.0-85050645336 (requires institutional sign-in at Scopus site)   62 Citations

Abstract

We studied the association between non-HLA donor characteristics (age, sex, donor-recipient relationship, blood group [ABO] match, and cytomegalovirus [CMV] serostatus) and transplant outcomes after T-cell-replete HLA-haploidentical transplantation using posttransplantation cyclophosphamide (PT-Cy) in 928 adults with hematologic malignancy transplanted between 2008 and 2015. Siblings (n = 358) and offspring (n = 450) were the predominant donors, with only 120 patients having received grafts from parents. Although mortality risks were higher with donors aged 30 years or older (hazard ratio, 1.39; P < .0001), the introduction of patient age to the Cox regression model negated the effect of donor age. Two-year survival adjusted for CMV seropositivity, disease, and disease risk index was lower in patients aged 55 to 78 years after transplantation of grafts from donors younger than 30 years (53%) or aged at least 30 years (46%) compared with younger patients who received grafts from donors younger than 30 years (61%) and at least 30 years (60%; P < .0001). Similarly, 2-year survival in patients aged 55 to 78 years was lower after transplantation of grafts from siblings (45%) or offspring (48%) compared with patients aged 18 to 54 years after transplantation of grafts from siblings (62%), offspring (58%), and parents (61%; P < .0001). Graft failure was higher after transplantation of grafts from parents (14%) compared with siblings (6%) or offspring (7%; P = .02). Other non-HLA donor characteristics were not associated with survival or graft failure. The current analyses suggest patient and disease, rather than non-HLA donor characteristics, predominantly influence survival in adults.

Author List

McCurdy SR, Zhang MJ, St Martin A, Al Malki MM, Bashey A, Gaballa S, Keesler DA, Hamadani M, Norkin M, Perales MA, Reshef R, Rocha V, Romee R, Solh M, Urbano-Ispizua A, Waller EK, Fuchs EJ, Eapen M

Authors

Mary Eapen MBBS, DCh, MRCPI, MS Professor in the Medicine department at Medical College of Wisconsin
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Factors
Aged
Cyclophosphamide
Graft Rejection
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Middle Aged
Nuclear Family
Siblings
Survival Analysis
Tissue Donors
Transplantation, Haploidentical
Young Adult