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Peripheral blood stem cell transplantation using HLA-haploidentical donor with post-transplant cyclophosphamide versus HLA-matched sibling donor for lymphoma

Bone Marrow Transplantation volume 59, pages 630–636 (2024)Cite this article

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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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Fig. 1: Hematopoietic engraftment and graft-versus-host disease according to donor type.
Fig. 2: Survival outcomes, relapse or progression, and non-relapse mortality by donor type.

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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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Authors and Affiliations

  1. Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

    Yosuke Nakaya & Hirohisa Nakamae

  2. Department of Hematology, Osaka City General Hospital, Osaka, Japan

    Yosuke Nakaya

  3. Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan

    Masashi Nishikubo & Nobuhiro Hiramoto

  4. Department of Hematology, Kawasaki Medical School, Kurashiki, Japan

    Eisei Kondo

  5. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  6. Hematology, Oncology and Cardiovascular medicine, Kyushu University Hospital, Fukuoka, Japan

    Yasuo Mori

  7. Division of Hematology and Oncology, Department of Medicine, Kurume University Hospital, Kurume, Japan

    Koji Nagafuji

  8. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  9. Department of Hematology, Tohoku University Hospital, Sendai, Japan

    Yasushi Onishi

  10. Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations TORANOMON HOSPITAL, Tokyo, Japan

    Naoyuki Uchida

  11. Department of Hematology, Osaka International Cancer Institute, Osaka, Japan

    Jun Ishikawa

  12. Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan

    Ken-ichi Matsuoka

  13. Department of Hematology, Nippon Medical School Hospital, Tokyo, Japan

    Shunsuke Yui

  14. Department of Hematology, NHO Kyusyu Medical Center, Fukuoka, Japan

    Ken Takase

  15. Department of Hematology, NHO Kumamoto Medical Center, Kumamoto, Japan

    Toshiro Kawakita

  16. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Junya Kanda

  17. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  18. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  19. Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan

    Yoshiko Atsuta

  20. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Shinichi Kako

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  1. Yosuke Nakaya
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Contributions

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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Correspondence to Hirohisa Nakamae.

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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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