Who is the better donor for older hematopoietic transplant recipients: an older-aged sibling or a young, matched unrelated volunteer? Journal Article
| Authors: | Alousi, A. M.; Le-Rademacher, J.; Saliba, R. M.; Appelbaum, F. R.; Artz, A.; Benjamin, J.; Devine, S. M.; Kan, F.; Laughlin, M. J.; Lazarus, H. M.; Liesveld, J.; Perales, M. A.; Maziarz, R. T.; Sabloff, M.; Waller, E. K.; Eapen, M.; Champlin, R. E. |
| Article Title: | Who is the better donor for older hematopoietic transplant recipients: an older-aged sibling or a young, matched unrelated volunteer? |
| Abstract: | Older patients are increasingly undergoing allogeneic hematopoietic transplantation. A relevant question is whether outcomes can be improved with a younger allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD). Accordingly, transplants in leukemia/lymphoma patients age ≥50 years were analyzed comparing outcomes for recipients of MSD ≥50 (n = 1415) versus MUD <50 years (n = 757). Risks of acute graft-versus-host disease (GVHD) grade 2 to 4 (hazard ratio [HR], 1.63; P < .001), 3 to 4 (HR, 1.85; P < .001), and chronic GVHD (HR, 1.48; P < .0001) were higher after MUD compared with MSD transplants. The effect of donor type on nonrelapse mortality (NRM), relapse, and overall mortality was associated with performance score. For patients with scores of 90 or 100, NRM (HR, 1.42; P = .001), relapse (HR, 1.45; P < .001), and overall mortality (HR, 1.28; P = .001) risks were higher after MUD transplants. For patients with scores below 90, NRM (HR, 0.96; P = .76), relapse (HR, 0.86; P = .25), and overall mortality (HR, 0.90; P = .29) were not significantly different after MUD and MSD transplants. These data favor an MSD over a MUD in patients age ≥50 years. |
| Keywords: | aged; middle aged; retrospective studies; transplantation, homologous; methodology; cohort studies; cohort analysis; hematopoietic stem cell transplantation; age factors; retrospective study; age; siblings; blood; evaluation; multicenter study; aging; sibling; donor selection; allotransplantation; human experiment; unrelated donors; blood group typing; blood grouping and crossmatching; human experimentation |
| Journal Title: | Blood |
| Volume: | 121 |
| Issue: | 13 |
| ISSN: | 0006-4971 |
| Publisher: | American Society of Hematology |
| Date Published: | 2013-03-28 |
| Start Page: | 2567 |
| End Page: | 2573 |
| Language: | English |
| DOI: | 10.1182/blood-2012-08-453860 |
| PUBMED: | 23361908 |
| PROVIDER: | scopus |
| PMCID: | PMC3612864 |
| DOI/URL: | |
| Notes: | --- - Cited By (since 1996):5 - "Export Date: 2 December 2013" - "Source: Scopus" |
