Post-HCT outcomes for older MSDs and younger MUDs
Nath K, Zhang M-J, Bye M, et al. Transplant Outcomes Using Older Matched Sibling Donors Compared to Young Alternative Donors: A CIBMTR Analysis. Blood Advances. 2025; (doi: 10.1182/bloodadvances.2024014858).
Study data suggest donor age and HLA status influence outcomes in older patients receiving post-transplant cyclophosphamide as graft-versus-host disease prophylaxis following hematopoietic cell transplantation (HCT). Researchers measured overall survival (OS) in 3,746 individuals aged ≥50 years who matched this patient profile, stratifying the results based on donor type. At median follow-up of 47 months years, the adjusted 5-year OS was 44% for transplant recipients with a matched sibling donor (MSD) aged 50 years or older. The result indicates no remarkable advantage in prioritizing older MSDs over younger alternative donors — including haploidentical donors, who had OS of 45%; HLA-mismatched unrelated donors, who had OS at 46%, and HLA-matched unrelated donors (MUDs), who had OS at 52%. Nonetheless, younger MUDs, if available, may be better-suited for older transplant patients due to improved disease-free survival compared with older MSDs (HR: 1.21, 1.05-1.40, p=0.048).