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Improved survival after offspring donor transplant compared with older aged‐matched siblings for older leukaemia patients
Author(s) -
Wang Yu,
Liu QiFa,
Wu DePei,
Xu LanPing,
Liu KaiYan,
Zhang XiaoHui,
Lu ShengYe,
Ma Xiao,
Huang Fen,
Huang XiaoJun
Publication year - 2020
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.16303
Subject(s) - offspring , medicine , sibling , incidence (geometry) , cumulative incidence , transplantation , human leukocyte antigen , immunology , pregnancy , antigen , biology , psychology , developmental psychology , genetics , physics , optics
Summary Donor selection for older leukaemia patients undergoing haematopoietic cell transplant (HCT) is not well defined: outcomes might be improved with a younger offspring donor rather than an older human leukocyte antigen (HLA)‐matched sibling donor (MSD). We extended our multicentre dataset. A total of 185 acute leukaemia patients (≥ 50 years) transplanted in first complete remission who received HCT from offspring ( n = 62) or MSD ( n = 123) were included. A 1:1 ratio matched‐pair analysis was performed. We were able to match 54 offspring with 54 MSD patients. Outcomes were compared between the two matched‐pair groups. The cumulative incidence of grade II/IV acute graft‐versus‐host disease (GVHD) (26% vs. 35%; P = 0·23) and chronic GVHD (37% vs. 24%; P = 0·19) was comparable between groups (MSD vs. offspring). The lower three‐year transplant‐related mortality (9% vs. 26%; P = 0·023) and relapse incidence (6% vs. 17%; P = 0·066) resulted in higher overall survival (85% vs. 58%; P = 0·003) and leukaemia‐free survival (LFS) (85% vs. 56%; P = 0·001) in offspring HCT compared with that in MSD HCT. These data might favour a young offspring over an older MSD in patients >50 years. The current analyses confirm that non‐HLA donor characteristics, such as kinship and donor age, rather than HLA disparity, predominantly influence survival in older acute leukaemia patients.