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Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry

Seber, Adriana
; 
Arcuri, Leonardo Javier
; 
Colturato, Vergilio Rensi
; 
Souza, Mair Pedro
; 
Zogbi, Yana Augusta Novis
; 
Funke, Vaneuza
; 
Lerner, Decio
; 
Macedo, Maria Cristina
; 
Daudt, Liane
; 
Kerbauy, Mariana Nassif
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Author
Seber, Adriana
Arcuri, Leonardo Javier
Colturato, Vergilio Rensi
Souza, Mair Pedro
Zogbi, Yana Augusta Novis
Funke, Vaneuza
Lerner, Decio
Macedo, Maria Cristina
Daudt, Liane
Kerbauy, Mariana Nassif
Zecchin, Victor Gottardello
Duarte, Fernando Barroso
Chiattone, Ricardo Rabello
Soares, Rodolfo Daniel de Almeida
Bettarello, Gustavo
Macedo, Antonio Vaz de
Paton, Eduardo
Monteiro, Tatiana Dias Marconi
Filho, Jayr Schmidt
Astigarraga, Claudia Caceres
Scheinberg, Phillip
Vigorito, Afonso Celso
Vergueiro, Carmen Silvia Vieitas
Simione, Anderson
Hashmi, Shahrukh
Saber, Wael
Patel, Jinalben
Bonfim, Carmem Maria Sales
Pasquini, Marcelo
Flowers, Mary Evelyn
Hamerschlak, Nelson
Supervisor
Department
Computer Vision
Embargo End Date
Type
Journal article
Date
2025
License
Language
English
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Abstract
Introduction: Over the last decades, the donor network for hematopoietic cell transplantation (HCT) has grown exponentially, including unrelated and haploidentical (Haplo) donors. This study aimed to describe HCT outcomes with MSD, Haplo, and matched unrelated donors (MUD) in an early period of Haplo with posttransplant cyclophosphamide in a developing country with a large unrelated donor registry. Methods: This study was conducted in collaboration with the CIBMTR. We included patients with acute leukemias undergoing HCT between 2014-2018. Results: With 595 patients, 2-year overall survival (OS) was 69% for the MSD, 65% for the Haplo, and 71% for MUD (p=0.24) in CR1, confirmed in multivariable analysis. Relapse rate was lower for MUD (HR=0.35, p=0.0005) than MSD in patients with CR2+, leading to higher OS. Relapse was also higher with Haplo compared with MUD (HR=2.06, p=0.03). Discussion: Only survival bias can explain these findings in CR2+, suggesting some high-risk MUD patients, in which HCT timing is crucial, may not achieve HCT. Alternative donors were associated with higher non-relapse mortality, while PTCy-based Haplo offered the best protection against chronic graft-versus-host disease. Our study suggests Haplo and MUD are acceptable options for patients lacking MSD in developing countries like ours.
Citation
A. Seber et al., “Haploidentical, matched-related, and matched-unrelated hematopoietic cell transplant for acute leukemias in the early years of haploidentical transplant implementation in a developing country with a large unrelated donor registry,” Front Oncol, vol. 15, p. 1584631, Apr. 2025, doi: 10.3389/FONC.2025.1584631.
Source
Frontiers in Oncology
Conference
Keywords
Hematopoietic cell transplantation, survival bias, acute lymphoblastic leukemia, haploidentical transplantation, unrelated donors, matched-related donors, posttransplant cyclophosphamide
Subjects
Source
Publisher
FRONTIERS MEDIA
DOI
10.3389/fonc.2025.1584631
Additional links
https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1584631/full
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