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- W4385077092 abstract "While allogeneic hematopoietic cell transplant (alloHCT) offers cures for older patients with acute lymphoblastic leukemia (ALL), disease relapse remains a major issue. Whether matched sibling donors (MSD) are still the preferred donor choice compared to younger matched unrelated donors (MUD), in the contemporary era of improved transplant practices, remains unknown. This retrospective cohort registry study queried the Center for International Blood and Marrow Transplant Research database (CIBMTR) data in B-cell ALL patients 50 years or older, undergoing alloHCT from older MSDs (donor age ≥ 50) or younger MUDs (donor age ≤ 35) between 2011 and 2018. The study included common allograft types, conditioning regimens, and graft versus host disease (GVHD) prophylaxis strategies. The primary outcome was relapse risk whereas secondary outcomes included non-relapse mortality (NRM), GVHD, leukemia-free survival (LFS), and overall survival (OS). Among 925 eligible patients in the study cohort, 386 underwent alloHCT with an older MSD (median donor age, 58) whereas 539 received transplant from a younger MUD (median donor age, 25). In multivariable analysis, younger MUDs conferred a significantly decreased risk of relapse (HR 0.68; p=.002) vs older MSDs. The adjusted cumulative incidence of relapse at 5 years was significantly lower with younger MUDs compared to older MSDs (26% vs 37%; p=.001). Younger MUDs were associated with a greater risk of chronic GVHD compared to older MSDs (HR 1.33; 95% CI, 1.10-1.61; p=.003). Compared to older MSDs, younger MUDs conferred an increased NRM (HR 1.38; p=.02) and higher adjusted cumulative incidence of NRM at 5 years (31% vs 22%; p=.006). There were no differences in OS or LFS rates of alloHCT with younger MUDs vs older MSDs (OS: HR 1.09; p=.37; DFS: HR 0.95; p=.57). Younger MUDs could be considered as a possible way to prevent relapse after alloHCT in older adults with ALL. Combining the use of younger MUDs with improved strategies to reduce GVHD is worth further exploration to improve outcomes." @default.
- W4385077092 created "2023-07-23" @default.
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- W4385077092 date "2023-10-01" @default.
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- W4385077092 title "Younger Matched Unrelated Donors Confer Decreased Relapse Risk Compared to Older Sibling Donors in Older Patients with B Cell Acute Lymphoblastic Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation" @default.
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- W4385077092 doi "https://doi.org/10.1016/j.jtct.2023.07.015" @default.
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