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<p>Allogeneic hematopoietic cell transplantation (alloHCT) from 8/10 HLA-matched unrelated donor is performed in a minority of patients. There is little data on its outcomes and consequently, guidelines on optimal transplantation procedures are lacking. The Transplant complications working party of the EBMT performed a registry study comparing approaches to graft-versus-host disease (GVHD) prophylaxis in recipients of alloHCT from 8/10 HLA-mismatched unrelated donors (8/10 MMUD). The analysis included 450 adult patients with hematological malignancies receiving a first alloHCT between 2015 and 2021, GVHD prophylaxis strategies included ATG in 318 and PTCy in 132 patients. AlloHCT from 8/10 MMUD resulted in 21.1% non-relapse mortality, 28.5% cumulative incidence of relapse, 55.7% overall survival (OS), 50.4% progression-free-survival and 39.8% GVHD-relapse-free survival (GRFS). PTCy decreased the risk of grade II-IV (HR 0.63, 95%CI 0.40–0.99) and III–IV acute GVHD (HR 0.31, 95%CI 0.13–0.74), improved OS (HR 0.63, 95%CI 0.41–0.95) and GRFS (HR 0.65, 95%CI 0.47–0.91). No other differences between the groups were documented. Transplantation from female donors to male recipients increased the incidence of extensive chronic GVHD (HR 2.39, 95%CI 1.10–5.19) and decreased PFS (HR 1.49, 95%CI 1.01–2.20). AlloHCT from 8/10 HLA-matched unrelated donor is feasible and the use of PTCy in GVHD prophylaxis improves outcomes.</p><p></p>

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Post-transplantation cyclophosphamide and antithymocyte globulin in 8/10 HLA-mismatched unrelated donor transplantation: the analysis on behalf of the transplant complications working party of the EBMT

  • 期刊论文

  • 发表日期：

    2025年8月19日

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  • Ivan Moiseev,
  • Mouad Abouqateb,
  • Christophe Peczynski,
  • Alessandro Busca,
  • Nicolaus Kröger,
  • Raffaella Cerretti,
  • Robert Zeiser,
  • Thomas Schroeder,
  • Matteo Parma,
  • Régis Peffault de Latour,
  • Wolfgang Bethge,
  • Jan Vydra,
  • Didier Blaise,
  • Victoria Panagiota,
  • Franca Fagioli,
  • William Boreland,
  • Hélène Schoemans,
  • Alberto Mussetti,
  • Charlotte Graham,
  • Olaf Penack,
  • Zinaida Peric

摘要

Allogeneic hematopoietic cell transplantation (alloHCT) from 8/10 HLA-matched unrelated donor is performed in a minority of patients. There is little data on its outcomes and consequently, guidelines on optimal transplantation procedures are lacking. The Transplant complications working party of the EBMT performed a registry study comparing approaches to graft-versus-host disease (GVHD) prophylaxis in recipients of alloHCT from 8/10 HLA-mismatched unrelated donors (8/10 MMUD). The analysis included 450 adult patients with hematological malignancies receiving a first alloHCT between 2015 and 2021, GVHD prophylaxis strategies included ATG in 318 and PTCy in 132 patients. AlloHCT from 8/10 MMUD resulted in 21.1% non-relapse mortality, 28.5% cumulative incidence of relapse, 55.7% overall survival (OS), 50.4% progression-free-survival and 39.8% GVHD-relapse-free survival (GRFS). PTCy decreased the risk of grade II-IV (HR 0.63, 95%CI 0.40–0.99) and III–IV acute GVHD (HR 0.31, 95%CI 0.13–0.74), improved OS (HR 0.63, 95%CI 0.41–0.95) and GRFS (HR 0.65, 95%CI 0.47–0.91). No other differences between the groups were documented. Transplantation from female donors to male recipients increased the incidence of extensive chronic GVHD (HR 2.39, 95%CI 1.10–5.19) and decreased PFS (HR 1.49, 95%CI 1.01–2.20). AlloHCT from 8/10 HLA-matched unrelated donor is feasible and the use of PTCy in GVHD prophylaxis improves outcomes.