HLA-Mismatched Donors in Patients with Myelodysplastic Syndrome

An EBMT Registry Analysis

Marie Robin, Raphaël Porcher, Annalisa Ruggeri, Didier Blaise, Christine Wolschke, Linda Koster, Emanuele Angelucci, Friedrich Stölzel, Victoria Potter, Ibrahim Yakoub-Agha, Yener Koc, Fabio Ciceri, Jürgen Finke, Hélène Labussière-Wallet, Maria Jesús Pascual Cascon, Mareike Verbeek, Alessandro Rambaldi, Jan J. Cornelissen, Patrice Chevallier, Rohini Radia & 5 others Arnon Nagler, Nathalie Fegueux, Eliane Gluckman, Theo de Witte, Nicolaus Kröger

Research output: Contribution to journalArticle

Abstract

Recently, haploidentical transplantation (haplo) using post-transplant cyclophosphamide (PTCy) has been reported to give very encouraging results in patients with hematological malignancies. Patients who have no HLA-matched donor currently have the choice between a mismatched unrelated donor, an unrelated cord blood (CB) donor, and a haploidentical related donor. The aim of our study is to compare the outcome of patients with myelodysplastic syndrome (MDS) who have been transplanted from a haploidentical donor using PTCy, an HLA-mismatched unrelated donor (marrow or peripheral blood stem cells), or an unrelated mismatched CB donor. A total of 833 MDS patients from the European Group for Blood and Marrow Transplantation (EBMT) registry, transplanted between 2011 and 2016, were identified. The potential benefit of haplo was compared with mismatched unrelated and CB donors in an adjusted and weighted model taking into account potential confounders and other prognostic variables. Haplo was at lower risk of acute graft-versus-host disease (GVHD) than mismatched unrelated donor (P =.010) but at similar risk than CB. Progression-free survival was better after haplo (versus mismatched unrelated, P =.056; versus CB, P =.003) and overall survival tended to be superior after haplo (versus mismatched unrelated, P =.082; versus CB, P =.002). Nonrelapse mortality was not significantly different between haplo and mismatched unrelated donors. Relapse risk was not influenced by the type of donor. In conclusion, patients with MDS from the EBMT registry receiving hematopoietic stem cell transplantation from a haplo donor have significantly better outcome than those receiving hematopoietic stem cell transplantation from a CB donor and at least similar or better outcome than with a mismatched unrelated donor. Prospective studies comparing the type of donors will be needed to confirm this assumption.

Original languageEnglish
JournalBiology of Blood and Marrow Transplantation
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Myelodysplastic Syndromes
Blood Group Antigens
Fetal Blood
Unrelated Donors
Registries
Transplantation
Bone Marrow
Tissue Donors
Blood Donors
Hematopoietic Stem Cell Transplantation
Cyclophosphamide
Transplants
Graft vs Host Disease
Hematologic Neoplasms
Disease-Free Survival
Prospective Studies
Recurrence
Survival
Mortality

Keywords

  • Haploidentical transplant
  • HLA-mismatched donor
  • MDS
  • Myelodysplastic syndrome

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

HLA-Mismatched Donors in Patients with Myelodysplastic Syndrome : An EBMT Registry Analysis. / Robin, Marie; Porcher, Raphaël; Ruggeri, Annalisa; Blaise, Didier; Wolschke, Christine; Koster, Linda; Angelucci, Emanuele; Stölzel, Friedrich; Potter, Victoria; Yakoub-Agha, Ibrahim; Koc, Yener; Ciceri, Fabio; Finke, Jürgen; Labussière-Wallet, Hélène; Cascon, Maria Jesús Pascual; Verbeek, Mareike; Rambaldi, Alessandro; Cornelissen, Jan J.; Chevallier, Patrice; Radia, Rohini; Nagler, Arnon; Fegueux, Nathalie; Gluckman, Eliane; de Witte, Theo; Kröger, Nicolaus.

In: Biology of Blood and Marrow Transplantation, 01.01.2018.

Research output: Contribution to journalArticle

Robin, M, Porcher, R, Ruggeri, A, Blaise, D, Wolschke, C, Koster, L, Angelucci, E, Stölzel, F, Potter, V, Yakoub-Agha, I, Koc, Y, Ciceri, F, Finke, J, Labussière-Wallet, H, Cascon, MJP, Verbeek, M, Rambaldi, A, Cornelissen, JJ, Chevallier, P, Radia, R, Nagler, A, Fegueux, N, Gluckman, E, de Witte, T & Kröger, N 2018, 'HLA-Mismatched Donors in Patients with Myelodysplastic Syndrome: An EBMT Registry Analysis', Biology of Blood and Marrow Transplantation. https://doi.org/10.1016/j.bbmt.2018.08.026
Robin, Marie ; Porcher, Raphaël ; Ruggeri, Annalisa ; Blaise, Didier ; Wolschke, Christine ; Koster, Linda ; Angelucci, Emanuele ; Stölzel, Friedrich ; Potter, Victoria ; Yakoub-Agha, Ibrahim ; Koc, Yener ; Ciceri, Fabio ; Finke, Jürgen ; Labussière-Wallet, Hélène ; Cascon, Maria Jesús Pascual ; Verbeek, Mareike ; Rambaldi, Alessandro ; Cornelissen, Jan J. ; Chevallier, Patrice ; Radia, Rohini ; Nagler, Arnon ; Fegueux, Nathalie ; Gluckman, Eliane ; de Witte, Theo ; Kröger, Nicolaus. / HLA-Mismatched Donors in Patients with Myelodysplastic Syndrome : An EBMT Registry Analysis. In: Biology of Blood and Marrow Transplantation. 2018.
@article{b56e99c68d564b20a329cc9e093aa389,
title = "HLA-Mismatched Donors in Patients with Myelodysplastic Syndrome: An EBMT Registry Analysis",
abstract = "Recently, haploidentical transplantation (haplo) using post-transplant cyclophosphamide (PTCy) has been reported to give very encouraging results in patients with hematological malignancies. Patients who have no HLA-matched donor currently have the choice between a mismatched unrelated donor, an unrelated cord blood (CB) donor, and a haploidentical related donor. The aim of our study is to compare the outcome of patients with myelodysplastic syndrome (MDS) who have been transplanted from a haploidentical donor using PTCy, an HLA-mismatched unrelated donor (marrow or peripheral blood stem cells), or an unrelated mismatched CB donor. A total of 833 MDS patients from the European Group for Blood and Marrow Transplantation (EBMT) registry, transplanted between 2011 and 2016, were identified. The potential benefit of haplo was compared with mismatched unrelated and CB donors in an adjusted and weighted model taking into account potential confounders and other prognostic variables. Haplo was at lower risk of acute graft-versus-host disease (GVHD) than mismatched unrelated donor (P =.010) but at similar risk than CB. Progression-free survival was better after haplo (versus mismatched unrelated, P =.056; versus CB, P =.003) and overall survival tended to be superior after haplo (versus mismatched unrelated, P =.082; versus CB, P =.002). Nonrelapse mortality was not significantly different between haplo and mismatched unrelated donors. Relapse risk was not influenced by the type of donor. In conclusion, patients with MDS from the EBMT registry receiving hematopoietic stem cell transplantation from a haplo donor have significantly better outcome than those receiving hematopoietic stem cell transplantation from a CB donor and at least similar or better outcome than with a mismatched unrelated donor. Prospective studies comparing the type of donors will be needed to confirm this assumption.",
keywords = "Haploidentical transplant, HLA-mismatched donor, MDS, Myelodysplastic syndrome",
author = "Marie Robin and Rapha{\"e}l Porcher and Annalisa Ruggeri and Didier Blaise and Christine Wolschke and Linda Koster and Emanuele Angelucci and Friedrich St{\"o}lzel and Victoria Potter and Ibrahim Yakoub-Agha and Yener Koc and Fabio Ciceri and J{\"u}rgen Finke and H{\'e}l{\`e}ne Labussi{\`e}re-Wallet and Cascon, {Maria Jes{\'u}s Pascual} and Mareike Verbeek and Alessandro Rambaldi and Cornelissen, {Jan J.} and Patrice Chevallier and Rohini Radia and Arnon Nagler and Nathalie Fegueux and Eliane Gluckman and {de Witte}, Theo and Nicolaus Kr{\"o}ger",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.bbmt.2018.08.026",
language = "English",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - HLA-Mismatched Donors in Patients with Myelodysplastic Syndrome

T2 - An EBMT Registry Analysis

AU - Robin, Marie

AU - Porcher, Raphaël

AU - Ruggeri, Annalisa

AU - Blaise, Didier

AU - Wolschke, Christine

AU - Koster, Linda

AU - Angelucci, Emanuele

AU - Stölzel, Friedrich

AU - Potter, Victoria

AU - Yakoub-Agha, Ibrahim

AU - Koc, Yener

AU - Ciceri, Fabio

AU - Finke, Jürgen

AU - Labussière-Wallet, Hélène

AU - Cascon, Maria Jesús Pascual

AU - Verbeek, Mareike

AU - Rambaldi, Alessandro

AU - Cornelissen, Jan J.

AU - Chevallier, Patrice

AU - Radia, Rohini

AU - Nagler, Arnon

AU - Fegueux, Nathalie

AU - Gluckman, Eliane

AU - de Witte, Theo

AU - Kröger, Nicolaus

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Recently, haploidentical transplantation (haplo) using post-transplant cyclophosphamide (PTCy) has been reported to give very encouraging results in patients with hematological malignancies. Patients who have no HLA-matched donor currently have the choice between a mismatched unrelated donor, an unrelated cord blood (CB) donor, and a haploidentical related donor. The aim of our study is to compare the outcome of patients with myelodysplastic syndrome (MDS) who have been transplanted from a haploidentical donor using PTCy, an HLA-mismatched unrelated donor (marrow or peripheral blood stem cells), or an unrelated mismatched CB donor. A total of 833 MDS patients from the European Group for Blood and Marrow Transplantation (EBMT) registry, transplanted between 2011 and 2016, were identified. The potential benefit of haplo was compared with mismatched unrelated and CB donors in an adjusted and weighted model taking into account potential confounders and other prognostic variables. Haplo was at lower risk of acute graft-versus-host disease (GVHD) than mismatched unrelated donor (P =.010) but at similar risk than CB. Progression-free survival was better after haplo (versus mismatched unrelated, P =.056; versus CB, P =.003) and overall survival tended to be superior after haplo (versus mismatched unrelated, P =.082; versus CB, P =.002). Nonrelapse mortality was not significantly different between haplo and mismatched unrelated donors. Relapse risk was not influenced by the type of donor. In conclusion, patients with MDS from the EBMT registry receiving hematopoietic stem cell transplantation from a haplo donor have significantly better outcome than those receiving hematopoietic stem cell transplantation from a CB donor and at least similar or better outcome than with a mismatched unrelated donor. Prospective studies comparing the type of donors will be needed to confirm this assumption.

AB - Recently, haploidentical transplantation (haplo) using post-transplant cyclophosphamide (PTCy) has been reported to give very encouraging results in patients with hematological malignancies. Patients who have no HLA-matched donor currently have the choice between a mismatched unrelated donor, an unrelated cord blood (CB) donor, and a haploidentical related donor. The aim of our study is to compare the outcome of patients with myelodysplastic syndrome (MDS) who have been transplanted from a haploidentical donor using PTCy, an HLA-mismatched unrelated donor (marrow or peripheral blood stem cells), or an unrelated mismatched CB donor. A total of 833 MDS patients from the European Group for Blood and Marrow Transplantation (EBMT) registry, transplanted between 2011 and 2016, were identified. The potential benefit of haplo was compared with mismatched unrelated and CB donors in an adjusted and weighted model taking into account potential confounders and other prognostic variables. Haplo was at lower risk of acute graft-versus-host disease (GVHD) than mismatched unrelated donor (P =.010) but at similar risk than CB. Progression-free survival was better after haplo (versus mismatched unrelated, P =.056; versus CB, P =.003) and overall survival tended to be superior after haplo (versus mismatched unrelated, P =.082; versus CB, P =.002). Nonrelapse mortality was not significantly different between haplo and mismatched unrelated donors. Relapse risk was not influenced by the type of donor. In conclusion, patients with MDS from the EBMT registry receiving hematopoietic stem cell transplantation from a haplo donor have significantly better outcome than those receiving hematopoietic stem cell transplantation from a CB donor and at least similar or better outcome than with a mismatched unrelated donor. Prospective studies comparing the type of donors will be needed to confirm this assumption.

KW - Haploidentical transplant

KW - HLA-mismatched donor

KW - MDS

KW - Myelodysplastic syndrome

UR - http://www.scopus.com/inward/record.url?scp=85058453705&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058453705&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2018.08.026

DO - 10.1016/j.bbmt.2018.08.026

M3 - Article

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

ER -