Abstract
Data comparing HLA-haploidentical donors and HLA-matched sibling donors (MSDs) in peripheral blood stem cell transplantation (PBSCT) for lymphoma are scarce. We retrospectively analyzed 465 patients with lymphoma aged 16 years or older who underwent PBSCT using haploidentical donors with post-transplant cyclophosphamide (PTCy-haplo) (n = 166) or MSDs with calcineurin inhibitor-based graft-versus-host disease (GVHD) prophylaxis (n = 299). Two-year overall survival (OS), progression-free survival (PFS), and GVHD-free, relapse-free survival (GRFS) in the PTCy-haplo and MSD groups were 49.2% versus 51.9% (P = 0.64), 38.0% versus 39.9% (P = 0.97), and 27.7% versus 18.5% (P = 0.006), respectively. In multivariable analyses, PTCy-haplo recipients had slower neutrophil recovery (hazard ratio [HR], 0.62; P < 0.001) and platelet recovery (HR, 0.54; P < 0.001), lower risk of chronic GVHD (HR, 0.64; P = 0.038) and extensive chronic GVHD (HR, 0.45; P = 0.008), and better GRFS (HR, 0.66; P = 0.003) than MSD transplant recipients. OS, PFS, relapse or progression, and non-relapse mortality were similar between the groups. The difference might be mainly due to PTCy use rather than donor type; however, the results suggested that PTCy-haplo could be a possible option as an alternative to conventional MSD transplantation for lymphoma in PBSCT.
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Data availability
The data of this study are not publicly available due to ethical restrictions that it exceeds the scope of the recipient/donor’s consent for research use in the registry. However, data may be available from the corresponding author upon reasonable request and with permission of the Japanese Society for Transplantation and Cellular Therapy (JSTCT)/ Japanese Data Center for Hematopoietic Cell Transplantation (JDCHCT).
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Acknowledgements
The authors deeply appreciate the physicians and data managers at the transplant centers who provided clinical data to the TRUMP2 database of the JDCHCT.
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YN and HN conceptualized the study, analyzed data, and wrote the first draft of the manuscript. MN, EK, TF, NH, YM, KN, TE, YO, NU, JI, KM, SY, KT, TK, JK, TI, YA, and SK interpreted the results and critically reviewed the manuscript. All authors contributed to data collection and approved the final version of the manuscript.
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Nakaya, Y., Nakamae, H., Nishikubo, M. et al. Peripheral blood stem cell transplantation using HLA-haploidentical donor with post-transplant cyclophosphamide versus HLA-matched sibling donor for lymphoma. Bone Marrow Transplant 59, 630–636 (2024). https://doi.org/10.1038/s41409-024-02229-y
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DOI: https://doi.org/10.1038/s41409-024-02229-y