Older MRD vs. younger MUD in patients older than 50 years with AML in remission using post-transplant cyclophosphamide.
Leukemia
; 38(9): 2016-2022, 2024 Sep.
Article
em En
| MEDLINE
| ID: mdl-39048722
ABSTRACT
An increasing number of older patients with acute myeloid leukemia (AML) are offered an allogeneic hematopoietic stem cell transplantation (allo-HSCT). Normally, older patients have older matched related donors (MRD). Matched unrelated donors (MUD) are an important alternative, but it remains unclear whether a younger MUD is associated with better outcomes, especially in the context of post-transplant cyclophosphamide (PTCy). We compared outcomes of patients older than 50 years with AML in first complete remission (CR1) and receiving a first HSCT from a 10/10 MUD aged younger than 40 years to those receiving a graft from a MRD aged older than 50 years, using PTCy and with well-known transplant conditioning intensity (TCI) score. A total of 345 consecutive patients were included and classified according to TCI score as low, intermediate, or high. On multivariable analysis in the TCI-intermediate/high group, MUD was associated with better graft-versus-host disease-free, relapse-free survival, lower non-relapse mortality and lower relapse incidence. For patients receiving a TCI-low regimen, outcomes are independent on the type of donor. In patients with AML in CR1, older than 50 years and receiving a TCI-intermediate/high conditioning regimen using PTCy, a MUD younger than 40 years is preferable over a MRD older than 50 years.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Indução de Remissão
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Leucemia Mieloide Aguda
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Transplante de Células-Tronco Hematopoéticas
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Condicionamento Pré-Transplante
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Ciclofosfamida
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article