Donor types and outcomes of transplantation in myelofibrosis: a CIBMTR study.
СтатьяПоддержка исследования: вне правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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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, Gupta Vikas
Аннотация
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.