Blood Advances (Dec 2024)
Outcomes of haploidentical transplants with PT-CY vs 10/10 MUD transplants with ATG in Germany
- Aysenur Arslan,
- Svenja Labuhn,
- Elisa Sala,
- Mark Ringhoffer,
- Johannes Schetelig,
- Thomas Schröder,
- Gesine Bug,
- Georg-Nikolaus Franke,
- Matthias Stelljes,
- Peter Dreger,
- Robert Zeiser,
- Daniel Teschner,
- Wolfgang Bethge,
- Matthias Eder,
- Matthias Edinger,
- Elisa Maria Amann,
- Christine Neuchel,
- Amelie Schmid-Möglich,
- Sandra Schmeller,
- Jan Beyersmann,
- Hubert Schrezenmeier,
- Joannis Mytilineos,
- Nicolaus Kröger,
- Daniel Fürst,
- Nicolaus Kröger,
- Thomas Schroeder,
- Matthias Stelljes,
- Peter Dreger,
- Robert Zeiser,
- Wolfgang Bethge,
- Daniel Teschner,
- Matthias Edinger,
- Uwe Platzbecker,
- Ahmet Elmaagacli,
- Inken Hilgendorf,
- Andreas Burchert,
- Friedrich Stölzel,
- Mareike Verbeek,
- Elisa Sala,
- Johanna Tischer,
- Johannes Schetelig,
- Arne Brecht,
- Martin Kaufmann,
- Christoph Kimmich,
- Jörg Thomas Bittenbring,
- Gerald Wulf,
- Igor Wolfgang Blau,
- Julia Winkler,
- Gesine Bug,
- Edgar Jost,
- Tobias Holderried,
- Mareike Dürholt,
- Christof Scheid,
- Eva Wagner-Drouet,
- Denise Wolleschak,
- Mark Ringhoffer,
- Michael Kiehl,
- Friederike Wortmann,
- Guido Kobbe,
- Roland Schroers,
- Angela Krackhardt,
- Stefan Klein,
- Lutz P. Müller,
- Christoph Schmid,
- Stephan Kaun,
- Ute Wieschermann,
- Tobias Bartscht,
- Ralf Georg Meyer,
- Matthias Wölfl,
- Peter Bader,
- Judith Niederland,
- Jakob Maucher,
- Christine Mauz-Körholz,
- Birgit Burkhardt,
- Karim Kentouche,
- Jakob Passweg,
- Karoline Ehlert
Affiliations
- Aysenur Arslan
- Department of Transplantation Immunology, Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg – Hessen, University Hospital Ulm, Ulm, Germany; Department of Transplantation Immunology, Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Svenja Labuhn
- Institute of Statistics, University of Ulm, Ulm, Germany
- Elisa Sala
- Department of Internal Medicine III, University Hospital Ulm, Ulm, Germany
- Mark Ringhoffer
- Department of Internal Medicine III, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
- Johannes Schetelig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany; DKMS, Clinical Trials Unit, Dresden, Germany
- Thomas Schröder
- Department of Hematology and Stem Cell Transplantation, West German Cancer Center Essen, University Hospital Essen, Essen, Germany
- Gesine Bug
- Department of Medicine 2, Hematology and Oncology, Goethe University Frankfurt, Frankfurt, Germany
- Georg-Nikolaus Franke
- Department of Hematology and Cellular Therapy, University of Leipzig, Leipzig, Germany
- Matthias Stelljes
- Department of Medicine A/Hematology and Oncology, University Hospital Münster, Münster, Germany
- Peter Dreger
- Department of Hematology and Oncology, University Hospital Heidelberg, Heidelberg, Germany
- Robert Zeiser
- Department of Medicine I/Hematology and Oncology, Faculty of Medicine, Freiburg Universiy Medical Center, Freiburg, Germany
- Daniel Teschner
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
- Wolfgang Bethge
- Department of Hematology and Oncology, University Hospital Tuebingen, Tuebingen, Germany
- Matthias Eder
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
- Matthias Edinger
- Department of Internal Medicine III, University Clinic Regensburg, Regensburg, Germany
- Elisa Maria Amann
- Department of Transplantation Immunology, Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg – Hessen, University Hospital Ulm, Ulm, Germany; Department of Transplantation Immunology, Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Christine Neuchel
- Department of Transplantation Immunology, Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg – Hessen, University Hospital Ulm, Ulm, Germany; Department of Transplantation Immunology, Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Amelie Schmid-Möglich
- Department of Transplantation Immunology, Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg – Hessen, University Hospital Ulm, Ulm, Germany; Department of Transplantation Immunology, Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Sandra Schmeller
- Institute of Statistics, University of Ulm, Ulm, Germany
- Jan Beyersmann
- Institute of Statistics, University of Ulm, Ulm, Germany
- Hubert Schrezenmeier
- Department of Transplantation Immunology, Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg – Hessen, University Hospital Ulm, Ulm, Germany; Department of Transplantation Immunology, Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
- Joannis Mytilineos
- ZKRD-Zentrales Knochenmarkspender-Register für Deutschland, German National Bone Marrow Donor Registry, Ulm, Germany
- Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Daniel Fürst
- Department of Transplantation Immunology, Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Transfusion Service, Baden Wuerttemberg – Hessen, University Hospital Ulm, Ulm, Germany; Department of Transplantation Immunology, Institute of Transfusion Medicine, University of Ulm, Ulm, Germany; Correspondence: Daniel Fürst, Department of Transplantation Immunology, Institute of Clinical Transfusion Medicine and Immunogenetics Ulm, Helmholtzstrasse 10, 89081 Ulm, Germany;
- Nicolaus Kröger
- Thomas Schroeder
- Matthias Stelljes
- Peter Dreger
- Robert Zeiser
- Wolfgang Bethge
- Daniel Teschner
- Matthias Edinger
- Uwe Platzbecker
- Ahmet Elmaagacli
- Inken Hilgendorf
- Andreas Burchert
- Friedrich Stölzel
- Mareike Verbeek
- Elisa Sala
- Johanna Tischer
- Johannes Schetelig
- Arne Brecht
- Martin Kaufmann
- Christoph Kimmich
- Jörg Thomas Bittenbring
- Gerald Wulf
- Igor Wolfgang Blau
- Julia Winkler
- Gesine Bug
- Edgar Jost
- Tobias Holderried
- Mareike Dürholt
- Christof Scheid
- Eva Wagner-Drouet
- Denise Wolleschak
- Mark Ringhoffer
- Michael Kiehl
- Friederike Wortmann
- Guido Kobbe
- Roland Schroers
- Angela Krackhardt
- Stefan Klein
- Lutz P. Müller
- Christoph Schmid
- Stephan Kaun
- Ute Wieschermann
- Tobias Bartscht
- Ralf Georg Meyer
- Matthias Wölfl
- Peter Bader
- Judith Niederland
- Jakob Maucher
- Christine Mauz-Körholz
- Birgit Burkhardt
- Karim Kentouche
- Jakob Passweg
- Karoline Ehlert
- Journal volume & issue
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Vol. 8,
no. 23
pp. 6104 – 6113
Abstract
Abstract: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the best curative treatment modality for many malignant hematologic disorders. In the absence of a matched related donor, matched unrelated donors (MUDs) and haploidentical donors are the most important stem cell sources. In this registry-based retrospective study, we compared the outcomes of allo-HSCTs from 10/10 MUDs with antithymocyte globulin (ATG)–based regimens (n = 7050) vs haploidentical transplants (Haplo-Tx) using posttransplant cyclophosphamide (PT-CY Haplo; n = 487) in adult patients with hematologic malignancies between 2010 and 2020. Cox proportional hazard-and competing risks regression models were formed to compare the outcomes. Overall survival (OS), Disease-free survival (DFS), and graft-versus-host disease (GVHD)–free and relapse-free survival (GRFS) were superior for 10/10 MUDs (OS [hazard ratio (HR), 1.27; 95% confidence interval (CI), 1.10-1.47; P = .001]; DFS [HR, 1.17; CI, 1.02-1.34; P = .022]; GRFS [HR, 1.34; CI, 1.19-1.50; P < .001]). The risk of acute GVHD (aGVHD) grade 2 to 4, aGVHD grade 3 to 4, and chronic GVHD (cGVHD) was higher in the PT-CY Haplo group than the 10/10 MUD group (aGVHD grade 2-4 [HR, 1.46; CI, 1.25-1.71; P < .001]; aGVHD grade 3-4 [HR, 1.74; CI, 1.37- 2.20; P < .001]; cGVHD [HR, 1.30; CI, 1.11-1.51; P = .001]). A lower incidence of relapse was observed in the PT-CY Haplo group (relapse: HR, 0.83; CI, 0.69-0.99; P = .038). Unrelated 10/10 matched transplantation with ATG leads to lower GVHD rates and improved survival rates compared with PT-CY Haplo transplantation in Germany.
