Donor age as an independent predictor of inferior outcomes after haploidentical hematopoietic cell transplantation in acute myeloid leukemia. Study conducted on behalf of GETH-TC
Por:
Munárriz, D, Pérez-Lopez, E, Rodríguez, CM, Luque, M, Esquirol, A, Calvo, CM, Aparicio, C, Peña-Muñoz, F, Fernando, IH, Ormtegi, IO, Marín, AJS, Fernández-Luis, S, Domínguez-García, JJ, Fernández, SV, Lopez-Lorenzo, JL, Fleitas, CA, González-Rodriguez, AP, García, L, Torrado, T, Filaferro, S, Balsalobre, P, Cascon, MJP, Rovira, M, Salas, MQ
Publicada:
28 nov 2025
Resumen:
This study evaluated the impact of donor age on clinical outcomes in 274 patients with acute myeloid leukemia (AML) haplo-HCT using PTCY-based prophylaxis. Median patient age was 53 years, with 42.6% classified as high-risk AML. The median donor age of 38 years; 31% were under 30. An optimal donor age cut-off of 30 years was identified through ROC analysis. Patients receiving grafts from younger donors (<30 years) showed lower rates of aGVHD grade II-IV (3.0% vs. 19.9%, p < 0.001) and grade III-IV (1.5% vs. 10.2%, p = 0.034), with no differences in cGVHD or relapse rates. Overall survival (OS) was higher in the younger donor group (2-year: 80.6% vs. 64.3%, p = 0.011), along by lower non-relapse mortality (NRM) (2-year: 11.1% vs. 23.2%, p = 0.031). Multivariate analysis confirmed donor age >= 30 years as an independent adverse factor for OS (HR: 1.88, p = 0.019) and NRM (HR: 2.06, p = 0.049), along with older recipient age, higher HCT-CI score, and high-risk AML. These findings suggest that younger donor age contributes to improved survival, primarily through reduced NRM and aGVHD, supporting prioritization of younger donors when multiple haploidentical options are available to optimize transplant outcomes.
Filiaciones:
Munárriz, D:
Hosp Clin Barcelona, Barcelona, Spain
Pérez-Lopez, E:
Complejo Asistencial Univ Salamanca, IBSAL, Salamanca, Spain
Rodríguez, CM:
Complejo Asistencial Univ Salamanca, IBSAL, Salamanca, Spain
Luque, M:
Hosp Reg Univ Malaga, Malaga, Spain
Esquirol, A:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Calvo, CM:
Hosp Reina Sofia Cordoba, Cordoba, Spain
Aparicio, C:
Hosp Reina Sofia Cordoba, Cordoba, Spain
Peña-Muñoz, F:
Hosp Duran i Reynals, Inst Catala Oncol, Barcelona, Spain
Fernando, IH:
Hosp Gen Univ Morales Meseguer, Murcia, Spain
Ormtegi, IO:
Hosp Univ Donostia, Donostia San Sebastian, Spain
Marín, AJS:
Hosp Univ 12 Octubre, Madrid, Spain
Fernández-Luis, S:
Hosp Univ Marques de Valdecilla, Santander, Spain
Domínguez-García, JJ:
Hosp Univ Marques de Valdecilla, Santander, Spain
Fernández, SV:
Clin Univ Navarra, Pamplona, Spain
Lopez-Lorenzo, JL:
Fdn Jimenez Diaz, Madrid, Spain
Fleitas, CA:
Hosp Univ Gran Canaria Doctor Negrin, Las Palmas Gran Canaria, Spain
González-Rodriguez, AP:
Hosp Univ Cent Asturias, Oviedo, Spain
García, L:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Torrado, T:
Hosp Univ A Coruna, La Coruna, Spain
Filaferro, S:
Grp Espanol Trasplante Progenitores Hematopoyet &, Madrid, Spain
Balsalobre, P:
Grp Espanol Trasplante Progenitores Hematopoyet &, Madrid, Spain
Cascon, MJP:
Hosp Reg Univ Malaga, Malaga, Spain
Grp Espanol Trasplante Progenitores Hematopoyet &, Madrid, Spain
Rovira, M:
Hosp Clin Barcelona, Barcelona, Spain
Grp Espanol Trasplante Progenitores Hematopoyet &, Madrid, Spain
Salas, MQ:
Hosp Clin Barcelona, Barcelona, Spain
Green Submitted, gold
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