Mismatched related donor allogeneic haematopoietic cell transplantation compared to other donor types for Ph+ chronic myeloid leukaemia: A retrospective analysis from the Chronic Malignancies Working Party of the EBMT

Francesco Onida*, Luuk Gras, Junran Ge, Linda Koster, Rose-Marie Hamladji, Jenny Byrne, Daniele Avenoso, Mahmoud Aljurf, Marie Robin, Kazimierz Halaburda, Jakob Passweg, Urpu Salmenniemi, Henrik Sengeloev, Jane Apperley, Andrew Clark, Péter Reményi, Elena Morozova, Francesca Kinsella, Stig Lenhoff, Arnold GanserKa Lung Wu, Antonio Perez-Martinez, Patrick J Hayden, Kavita Raj, Joanna Drozd-Sokolowska, Guillermo OrtÍ, Hugues de Lavallade, Ibrahim Yakoub-Agha, Donal P McLornan, Yves Chalandon

*Corresponding author af dette arbejde

Abstract

Allogeneic haematopoietic cell transplantation (allo-HCT) remains an option for tyrosine kinase inhibitor-resistant chronic myeloid leukaemia (CML) in first chronic phase (CP1) and high-risk patients with advanced disease phases. In this European Society for Blood and Marrow Transplantation (EBMT) registry-based study of 1686 CML patients undergoing first allo-HCT between 2012 and 2019, outcomes were evaluated according to donor type, particularly focusing on mismatched related donors (MMRDs). Median age at allo-HCT was 46 years (IQR 36-55). Disease status was CP1 in 43%, second CP (CP2) or later in 27%, accelerated phase in 12% and blast crisis in 18%. Donor type was matched related (MRD) in 39.2%, MMRD in 8.1%, matched unrelated (MUD) in 40.2%, and mismatched unrelated (MMUD) in 12.6%. In 4 years, overall survival (OS) for MRD, MMRD, MUD and MMUD was 61%, 56%, 63% and 59% (p = 0.21); relapse-free survival (RFS) was 48%, 42%, 52% and 46% (p = 0.03); cumulative incidence of relapse (CIR) was 33%, 37%, 27% and 30% (p = 0.07); non-relapse mortality (NRM) was 19%, 21%, 21% and 24% (p = 0.21); and graft-versus-host disease (GvHD)-free/relapse-free survival (GRFS) was 16%, 18%, 22% and 15% (p = 0.05) respectively. On multivariate analysis, MMRD use associated with longer engraftment times and higher risk of graft failure compared to MRD or MUD. There was no statistical evidence that MMRD use associated with different OS, RFS and incidence of GvHD compared to other donor types.

OriginalsprogEngelsk
TidsskriftBritish Journal of Haematology
ISSN0007-1048
DOI
StatusE-pub ahead of print - 5 apr. 2024

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