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Comparison of non-first-degree related donors and first-degree related donors in haploidentical HSCT: a multi-centre retrospective analysis

Bone Marrow Transplantation volume 56, pages 2567–2574 (2021)Cite this article

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Abstract

The transplant outcomes of non-first-degree (NFD) related donors in haploidentical haematopoietic stem cell transplantation (haplo-HSCT) remain unclear. This multi-centre analysis compared NFD and first-degree (FD) related donors in haplo-HSCT using a low-dose anti-T-lymphocyte globulin/G-CSF-mobilised peripheral blood stem cell graft-based regimen. Ninety-nine patients (33 NFD; 66 FD) were included. All patients achieved myeloid and platelet engraftment. The 100-day cumulative incidence (CI) of aGVHD, 2-year CIs of relapse, cGVHD, and NRM, and 2-year probabilities of OS and GRFS were comparable between the two cohorts. In multivariate analysis, donor type (NFD vs. FD) had no impact on OS, PFS, GRFS, incidences of relapse, grade II–IV aGVHD or moderate–severe cGVHD. Older donor age was associated with a higher incidence of grade II–IV aGVHD (HR, 1.64, p = 0.03), moderate–severe cGVHD (HR, 1.92, p = 0.01) and worse GRFS (HR, 1.40, p = 0.02). A lower level of donor–recipient HLA matching was associated with a higher incidence of moderate–severe cGVHD (HR, 4.07, p = 0.02), and disease at complete remission was associated with better OS (HR, 0.21, p = 0.01) and PFS (HR, 0.3, p = 0.03). In conclusion, NFD donors may serve as feasible alternatives when FD donors are not available for haplo-HSCT.

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Fig. 1: Haplo-HSCT outcomes comparing non-first-degree related donors and first-degree related donors.

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Acknowledgements

This study was supported by the National Key Basic Research Programme of China (grant # 2018YFA0107804), the National Science Foundation of China (grant # NSFC81730008, NSFC81970158 and NSFC82000180) and the Zhejiang Key R&D Programme (Science and Technology Department) (grant # 2019C03016).

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Author notes

  1. These authors contributed equally: Mohamad Mohty, He Huang, Yi Luo

Authors and Affiliations

  1. Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Yishan Ye, Mowang Wang, Jimin Shi, Yamin Tan, Yanmin Zhao, Jian Yu, Xiaoyu Lai, Yibo Wu, Luxin Yang, Fei Gao, He Huang & Yi Luo

  2. Institute of Hematology, Zhejiang University, Hangzhou, China

    Yishan Ye, Mowang Wang, Jimin Shi, Yamin Tan, Yanmin Zhao, Jian Yu, Xiaoyu Lai, Yibo Wu, Luxin Yang, Fei Gao, He Huang & Yi Luo

  3. AP-HP, Service d’Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France

    Florent Malard & Mohamad Mohty

  4. The Affiliated People’s Hospital of Ningbo University, Ningbo, China

    Ying Lu

  5. Ningbo Hospital of Zhejiang University, Ningbo, China

    Guifang Ouyang

  6. Zhejiang Provincial People’s Hospital, Hangzhou, China

    Jianping Lan

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Correspondence to Mohamad Mohty, He Huang or Yi Luo.

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Ye, Y., Wang, M., Malard, F. et al. Comparison of non-first-degree related donors and first-degree related donors in haploidentical HSCT: a multi-centre retrospective analysis. Bone Marrow Transplant 56, 2567–2574 (2021). https://doi.org/10.1038/s41409-021-01352-4

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