title: The outcomes of family haploidentical hematopoietic stem cell transplantation in hematologic malignancies are not associated with patient age.
abstract: Haploidentical hematopoietic cell transplantation (HCT) has been used to treat hematologic malignancies, but it is unknown whether the procedure is more effective in adults or children. To address this question, we analyzed patients aged 1 to 65 years old receiving myeloablative conditioning regimens followed by family 2 to 3 antigen HLA-mismatched HCT and reported to the Center for International Blood and Marrow Transplant Research (CIBMTR; n = 137) or performed in Dao-Pei Hospital in China, China (n = 181). The Dao-Pei cohort had more acute and chronic graft-versus-host disease (GVHD), less relapse, lower transplant-related mortality (TRM), and better leukemia-free survival (LFS) than the CIBMTR cohort. Overall survival (OS) and outcomes were similar between adults and children. In the CIBMTR cohort receiving ex vivo T cell depletion (TCD), adults had higher TRM (relative risk [RR] 2.71, 95% confidence interval [CI] 1.29-5.69, P = .008) and lower OS (RR 1.75, 95% CI 1.08-2.84, P = .023) than children. In the CIBMTR subset that did not receive ex vivo TCD, relapse was lower in adults compared to children (RR 0.24, 95% CI 0.07-0.80, P = .020), but TRM, LFS, and OS were similar. We conclude that outcomes in adults and children are similar overall, although children have better survival than adults if ex vivo TCD is used.
authors.affiliation: Fu Dan University Institute of Hematology, BMT Center, Dao-Pei Hospital, Shanghai, People's Republic of China. lujialidong@yahoo.com.cn
authors.forename: Lujia
authors.initials: L
authors.lastname: Dong
authors.forename: Tong
authors.initials: T
authors.lastname: Wu
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Gao
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.forename: Fangyu
authors.initials: F
authors.lastname: Kan
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Spellman
authors.forename: Xi-You
authors.initials: XY
authors.lastname: Tan
authors.forename: Yan-Li
authors.initials: YL
authors.lastname: Zhao
authors.forename: Jing-Bo
authors.initials: JB
authors.lastname: Wang
authors.forename: Dao-Pei
authors.initials: DP
authors.lastname: Lu
authors.forename: David
authors.initials: D
authors.lastname: Miklos
authors.forename: Effie
authors.initials: E
authors.lastname: Petersdorf
authors.forename: Marcelo
authors.initials: M
authors.lastname: Fernandez-Vina
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000235:genetics / Q000276:immunology / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods; D016896:Treatment Outcome