Outcome after allogeneic stem cell transplantation with haploidentical versus HLA-matched donors in patients with higher-risk MDS - Institut Paoli-Calmettes
Article Dans Une Revue Bone Marrow Transplantation Année : 2023

Outcome after allogeneic stem cell transplantation with haploidentical versus HLA-matched donors in patients with higher-risk MDS

1 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
2 AP-HP - Hopital Saint-Louis [AP-HP]
3 Sans affiliation
4 IPC - Institut Paoli-Calmettes
5 University Hospitals Leuven [Leuven]
6 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
7 IGR - Institut Gustave Roussy
8 Hôpital Haut-Lévêque [CHU Bordeaux]
9 Hôpital Saint Eloi [CHU Montpellier]
10 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
11 INFINITE - Institute for Translational Research in Inflammation - U 1286
12 Cliniques Universitaires Saint-Luc [Bruxelles]
13 Hôpital Michallon
14 CHU Estaing [Clermont-Ferrand]
15 CHU-Liège - Centre Hospitalier Universitaire de Liège
16 Hôpital l'Archet
17 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
18 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
19 CHU Angers - Centre Hospitalier Universitaire d'Angers
20 Centre Hospitalier Universitaire [Rennes]
21 CHU Saint-Antoine [AP-HP]
22 Hôpital Necker - Enfants Malades [AP-HP]
23 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
24 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
25 UNIGE - Université de Genève = University of Geneva
26 HUG - Hôpitaux universitaires de Genève = University Hospitals of Geneva
27 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
28 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
29 CHU Amiens-Picardie
30 Hôpital Dupuytren [CHU Limoges]
31 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
32 CHU Caen
33 Hôpital Henri Mondor
34 AUB - American University of Beirut [Beyrouth]
35 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
36 CHU Pitié-Salpêtrière [AP-HP]
Martin Carre
  • Fonction : Auteur
Michael Loschi
  • Fonction : Auteur
Sylvain Chantepie
  • Fonction : Auteur

Résumé

Allogeneic hematopoietic stem cell transplantation remains the best curative option for higher-risk myelodysplastic syndrome. The presence of monosomal karyotype and/or complex karyotype abnormalities predicts inferior survival after allo-SCT in MDS patients. Haploidentical allo-SCT has been increasingly used in acute leukemia (AL) and has similar results as using HLA-matched donors, but data on higher-risk MDS is sparse. We compared outcomes in 266 patients with higher-risk MDS after HLA-matched sibling donor (MSD, n = 79), HLA-matched unrelated donor (MUD, n = 139) and HLA haploidentical donor (HID, n = 48) from 2010 to 2019. Median donor age differed between the three groups (p < 0.001). The overall survival was significantly different between the three groups with a better OS observed in the MUD group (p = 0.014). This observation could be explained by a higher progression-free survival with MUD (p = 0.014). The cumulative incidence of grade 2–4 acute GvHD was significantly higher in the HID group (p = 0.051). However, in multivariable analysis, patients transplanted using an HID had comparable mortality to patients transplanted using a MUD (subdistribution hazard ratio [sHR]: 0.58 [0.32–1.07]; p = 0.080) and a MSD ([sHR]: 0.56 [0.28–1.11]; p = 0.094). MUD do not remain a significant positive predictor of survival, suggesting that beyond the donor-recipient HLA matching, the donor age might impact recipient outcome.
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hal-04672661 , version 1 (02-09-2024)

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Claire Michel, Marie Robin, Stephane Morisset, Didier Blaise, Johan Maertens, et al.. Outcome after allogeneic stem cell transplantation with haploidentical versus HLA-matched donors in patients with higher-risk MDS. Bone Marrow Transplantation, 2023, Bone Marrow Transplantation, 58 (5), pp.534-543. ⟨10.1038/s41409-023-01931-7⟩. ⟨hal-04672661⟩
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