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Article Dans Une Revue Biology of Blood and Marrow Transplantation Année : 2019

HLA mismatched donors in patients with myelodysplastic syndrome: an EBMT registry analysis.

Annalisa Ruggeri
  • Fonction : Auteur
Christine Wolschke
  • Fonction : Auteur
Linda Koster
  • Fonction : Auteur
Emanuele Angelucci
  • Fonction : Auteur
Friedrich Stolzel
  • Fonction : Auteur
Victoria Potter
  • Fonction : Auteur
Yener Koc
  • Fonction : Auteur
Fabio Ciceri
  • Fonction : Auteur
Jurgen Finke
  • Fonction : Auteur
Helene Labussiere-Wallet
  • Fonction : Auteur
Pascual Cascon Maria Jesus
  • Fonction : Auteur
Mareike Verbeek
  • Fonction : Auteur
Alessandro Rambaldi
  • Fonction : Auteur
J Cornelissen Jan
  • Fonction : Auteur
Patrice Chevallier
  • Fonction : Auteur
Rohini Radia
  • Fonction : Auteur
Arnon Nagler
  • Fonction : Auteur
Nathalie Fegueux
  • Fonction : Auteur
Eliane Gluckman
  • Fonction : Auteur
Theo de Witte
  • Fonction : Auteur

Résumé

Recently, haploidentical transplantation (haplo) using post-transplant cyclophosphamide (PTCy) has been reported to give very encouraging results in patients with hematological malignancies. Patients who have no HLA-matched donor currently have the choice between a mismatched unrelated donor, an unrelated cord blood (CB) donor, and a haploidentical related donor. The aim of our study is to compare the outcome of patients with myelodysplastic syndrome (MDS) who have been transplanted from a haploidentical donor using PTCy, an HLA-mismatched unrelated donor (marrow or peripheral blood stem cells), or an unrelated mismatched CB donor. A total of 833 MDS patients from the European Group for Blood and Marrow Transplantation (EBMT) registry, transplanted between 2011 and 2016, were identified. The potential benefit of haplo was compared with mismatched unrelated and CB donors in an adjusted and weighted model taking into account potential confounders and other prognostic variables. Haplo was at lower risk of acute graft-versus-host disease (GVHD) than mismatched unrelated donor (P = .010) but at similar risk than CB. Progression-free survival was better after haplo (versus mismatched unrelated, P = .056; versus CB, P = .003) and overall survival tended to be superior after haplo (versus mismatched unrelated, P = .082; versus CB, P = .002). Nonrelapse mortality was not significantly different between haplo and mismatched unrelated donors. Relapse risk was not influenced by the type of donor. In conclusion, patients with MDS from the EBMT registry receiving hematopoietic stem cell transplantation from a haplo donor have significantly better outcome than those receiving hematopoietic stem cell transplantation from a CB donor and at least similar or better outcome than with a mismatched unrelated donor. Prospective studies comparing the type of donors will be needed to confirm this assumption.

Dates et versions

hal-04318265 , version 1 (01-12-2023)

Identifiants

Citer

Marie Robin, Raphael Porcher, Annalisa Ruggeri, Didier Blaise, Christine Wolschke, et al.. HLA mismatched donors in patients with myelodysplastic syndrome: an EBMT registry analysis.. Biology of Blood and Marrow Transplantation, 2019, Biology of Blood and Marrow Transplantation, 25, pp.114-120. ⟨10.1016/j.bbmt.2018.08.026⟩. ⟨hal-04318265⟩
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