PMID- 36990221 OWN - NLM STAT- MEDLINE DCOM- 20230605 LR - 20230608 IS - 2666-6367 (Electronic) IS - 2666-6375 (Print) IS - 2666-6367 (Linking) VI - 29 IP - 6 DP - 2023 Jun TI - Impact of Donor Age in Haploidentical-Post-Transplantation Cyclophosphamide versus Matched Unrelated Donor Post-Transplantation Cyclophosphamide Hematopoietic Stem Cell Transplantation in Patients with Acute Myeloid Leukemia. PG - 377.e1-377.e7 LID - S2666-6367(23)01203-4 [pii] LID - 10.1016/j.jtct.2023.03.028 [doi] AB - Haploidentical hematopoietic cell transplantation (HCT) with post-transplantation cyclophosphamide (PTCy) graft-versus-host-disease (GVHD) prophylaxis is associated with inferior overall survival (OS) compared to HLA-matched unrelated donor (MUD) HCT with PTCy prophylaxis in patients receiving reduced-intensity conditioning (RIC). Given prognostic implications of donor age, we investigated the differences in outcomes of patients with acute myeloid leukemia (AML; n = 775) undergoing RIC-HCT with a younger MUD (age <35 years; n = 84) versus a younger haploidentical donor (age <35 years; n = 302) versus an older haploidentical donor (age >/=35 years; n = 389). The older MUD group was excluded from the analysis because of small numbers. The younger haploidentical donor group (median age, 59.5 years) was somewhat younger than the younger MUD group (median age, 66.8 years) and the older haploidentical donor group (median age, 64.7 years). More patients in the MUD group received peripheral blood grafts (82%) compared to the haploidentical donor groups (55% to 56%). In multivariate analysis, compared to the younger MUD group, the younger haploidentical donor group (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.22 to 3.12; P = .005) and the older haploidentical donor group (HR, 2.36; 95% CI, 1.50 to 3.71; P < .001) had a significantly inferior OS, and the younger haploidentical donor group (HR, 3.72; 95% CI, 1.39 to 9.93; P = .009) and older haploidentical donor group (HR, 6.91; 95% CI, 2.75 to 17.39; P < .001) had a significantly higher risk of nonrelapse mortality. The older haploidentical group had a significantly higher risk of grade II-IV acute GVHD (HR, 2.29; 95% CI, 1.38 to 3.80; P = .001) and grade III-IV acute GVHD (HR, 2.70; 95% CI, 1.09 to 6.71; P = .03). There were no significant differences across the groups in the incidence of chronic GVHD or relapse. Among adult AML patients in CR undergoing RIC-HCT with PTCy prophylaxis, a young MUD may be preferred over a young haploidentical donor. CI - Copyright (c) 2023 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved. FAU - Mehta, Rohtesh S AU - Mehta RS AD - Clinical Research Division, Adult Blood and Marrow Transplantation, Fred Hutchison Cancer Center, Seattle, Washington. Electronic address: rmehta@fredhutch.org. FAU - Ramdial, Jeremy AU - Ramdial J AD - Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas. FAU - Marin, David AU - Marin D AD - Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas. FAU - Alousi, Amin AU - Alousi A AD - Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas. FAU - Kanakry, Christopher G AU - Kanakry CG AD - Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland. FAU - Champlin, Richard E AU - Champlin RE AD - Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas. FAU - Rezvani, Katayoun AU - Rezvani K AD - Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas. FAU - Shpall, Elizabeth J AU - Shpall EJ AD - Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas. FAU - Page, Kristin AU - Page K AD - Division of Pediatric Hematology, Oncology, and Transplant, Medical College of Wisconsin, Milwaukee, Wisconsin. FAU - Gadalla, Shahinaz M AU - Gadalla SM AD - Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland. FAU - Kebriaei, Partow AU - Kebriaei P AD - Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas. FAU - Weisdorf, Daniel AU - Weisdorf D AD - Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. LA - eng GR - P30 CA016672/CA/NCI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20230328 PL - United States TA - Transplant Cell Ther JT - Transplantation and cellular therapy JID - 101774629 RN - 8N3DW7272P (Cyclophosphamide) SB - IM MH - Adult MH - Humans MH - Middle Aged MH - Aged MH - Unrelated Donors MH - *Hematopoietic Stem Cell Transplantation MH - Cyclophosphamide/therapeutic use MH - *Leukemia, Myeloid, Acute/drug therapy MH - *Graft vs Host Disease/prevention & control/drug therapy PMC - PMC10239355 MID - NIHMS1886607 OTO - NOTNLM OT - AML OT - Acute myeloid leukemia OT - Donor age OT - Haploidentical donor OT - Matched unrelated donor OT - Older donor OT - Relapse OT - Survival OT - Younger donor COIS- Disclosure of Conflicts of Interest: No relevant COI to declare. EDAT- 2023/03/30 06:00 MHDA- 2023/06/05 06:42 PMCR- 2024/06/01 CRDT- 2023/03/29 19:31 PHST- 2023/02/06 00:00 [received] PHST- 2023/03/14 00:00 [revised] PHST- 2023/03/22 00:00 [accepted] PHST- 2024/06/01 00:00 [pmc-release] PHST- 2023/06/05 06:42 [medline] PHST- 2023/03/30 06:00 [pubmed] PHST- 2023/03/29 19:31 [entrez] AID - S2666-6367(23)01203-4 [pii] AID - 10.1016/j.jtct.2023.03.028 [doi] PST - ppublish SO - Transplant Cell Ther. 2023 Jun;29(6):377.e1-377.e7. doi: 10.1016/j.jtct.2023.03.028. Epub 2023 Mar 28.