Document Type
Article
Publication Date
8-27-2024
Abstract
We evaluate the impact of donor types on outcomes of hematopoietic cell transplantation (HCT) in myelofibrosis, using the Center for International Blood and Marrow Transplant Research registry data for HCTs done between 2013 and 2019. In all 1597 patients, the use of haploidentical donors increased from 3% in 2013 to 19% in 2019. In study-eligible 1032 patients who received peripheral blood grafts for chronic-phase myelofibrosis, 38% of recipients of haploidentical HCT were non-White/Caucasian. Matched sibling donor (MSD)-HCTs were associated with superior overall survival (OS) in the first 3 months (haploidentical hazard ratio [HR], 5.80 [95% confidence interval (CI), 2.52-13.35]; matched unrelated (MUD) HR, 4.50 [95% CI, 2.24-9.03]; mismatched unrelated HR, 5.13 [95% CI, 1.44-18.31]; P < .001). This difference in OS aligns with lower graft failure with MSD (haploidentical HR, 6.11 [95% CI, 2.98-12.54]; matched unrelated HR, 2.33 [95% CI, 1.20-4.51]; mismatched unrelated HR, 1.82 [95% CI, 0.58-5.72]). There was no significant difference in OS among haploidentical, MUD, and mismatched unrelated donor HCTs in the first 3 months. Donor type was not associated with differences in OS beyond 3 months after HCT, relapse, disease-free survival, or OS among patients who underwent HCT within 24 months of diagnosis. Patients who experienced graft failure had more advanced disease and commonly used nonmyeloablative conditioning. Although MSD-HCTs were superior, there is no significant difference in HCT outcomes from haploidentical and MUDs. These results establish haploidentical HCT with posttransplantation cyclophosphamide as a viable option in myelofibrosis, especially for ethnic minorities underrepresented in the donor registries.
Recommended Citation
Jain, Tania; Estrada-Merly, Noel; Salas, M Queralt; Kim, Soyoung; DeVos, Jakob; Chen, Min; Fang, Xi; Kumar, Rajat; Andrade-Campos, Marcio; Elmariah, Hany; Agrawal, Vaibhav; Aljurf, Mahmoud; Bacher, Ulrike; Badar, Talha; Badawy, Sherif M; Ballen, Karen; Beitinjaneh, Amer; Bhatt, Vijaya Raj; Bredeson, Christopher; DeFilipp, Zachariah; Dholaria, Bhagirathbhai; Farhadfar, Nosha; Farhan, Shatha; Gandhi, Arpita P; Ganguly, Siddhartha; Gergis, Usama; Grunwald, Michael R; Hamad, Nada; Hamilton, Betty K; Inamoto, Yoshihiro; Iqbal, Madiha; Jamy, Omer; Juckett, Mark; Kharfan-Dabaja, Mohamed A; Krem, Maxwell M; Lad, Deepesh P; Liesveld, Jane; Al Malki, Monzr M; Malone, Adriana K; Murthy, Hemant S; Ortí, Guillermo; Patel, Sagar S; Pawarode, Attaphol; Perales, Miguel-Angel; van der Poel, Marjolein; Ringden, Olle; Rizzieri, David A; Rovó, Alicia; Savani, Bipin N; Savoie, Mary Lynn; Seo, Sachiko; Solh, Melhem; Ustun, Celalettin; Verdonck, Leo F; Wingard, John R; Wirk, Baldeep; Bejanyan, Nelli; Jones, Richard J; Nishihori, Taiga; Oran, Betul; Nakamura, Ryotaro; Scott, Bart; Saber, Wael; and Gupta, Vikas, "Donor Types and Outcomes of Transplantation in Myelofibrosis: a CIBMTR Study" (2024). Department of Medical Oncology Faculty Papers. Paper 274.
https://jdc.jefferson.edu/medoncfp/274
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
38916866
Language
English
Comments
This article is the author's final published version in Blood Advances, Volume 8, Issue 16, August 2024, Pages 4281 - 4293.
The published version is available at https:/doi.org/10.1182/bloodadvances.2024013451
Copyright © 2024 by The American Society of Hematology