我们旨在评估供体类型对骨髓纤维化造血细胞移植(HCT)结果的影响,使用2013年至2019年期间完成的HCT的CIBMTR注册数据。在所有1597年因骨髓纤维化而接受HCT的患者中,单倍体供体的使用量从2013年的3%增加到2019年的19%。在符合资格的研究中,1032例接受慢性期骨髓纤维化外周血移植的患者,38%的单倍体HCT接受者是非白人/白种人。配对同胞供体(MSD)-HCTs与前3个月的总生存期(OS)独立相关[参考MSD,单倍体HR5.80(95%CI2.52-13.35),匹配的无关HR4.50(95%CI2.24-9.03),和不匹配的无关HR5.13(95%CI1.44-18.31),P<0.001]。OS的这种差异与MSD的较低移植物失败相符[单倍体HR6.11(95CI2.98-12.54),匹配的无关HR2.33(95CI1.20-4.51),错配的无关HR1.82(95CI0.58-5.72)。单倍体之间的OS没有显着差异,匹配无关,和前3个月不匹配的无关供体HCTs。供体类型与HCT后3个月后的OS差异无关,复发,诊断后24个月内接受HCT的患者的无病生存期或OS.经历移植失败的患者患有更晚期的疾病,并且通常使用非清髓性预处理。虽然MSD仍然是一个优越的供体选择,由于提高了植入,来自单倍体相合和匹配无关供体的HCT结局无显著差异.这些结果建立了单倍体-HCT与移植后环磷酰胺作为骨髓纤维化的可行选择。特别是对于在捐助者登记册中代表性不足的少数民族。
UNASSIGNED: We evaluate the impact of donor types on outcomes of hematopoietic cell transplantation (HCT) in myelofibrosis, using the Center for International Blood and Marrow Transplant Research registry data for HCTs done between 2013 and 2019. In all 1597 patients, the use of haploidentical donors increased from 3% in 2013 to 19% in 2019. In study-eligible 1032 patients who received peripheral blood grafts for chronic-phase myelofibrosis, 38% of recipients of haploidentical HCT were non-White/Caucasian. Matched sibling donor (MSD)-HCTs were associated with superior overall survival (OS) in the first 3 months (haploidentical hazard ratio [HR], 5.80 [95% confidence interval (CI), 2.52-13.35]; matched unrelated (MUD) HR, 4.50 [95% CI, 2.24-9.03]; mismatched unrelated HR, 5.13 [95% CI, 1.44-18.31]; P < .001). This difference in OS aligns with lower graft failure with MSD (haploidentical HR, 6.11 [95% CI, 2.98-12.54]; matched unrelated HR, 2.33 [95% CI, 1.20-4.51]; mismatched unrelated HR, 1.82 [95% CI, 0.58-5.72]). There was no significant difference in OS among haploidentical, MUD, and mismatched unrelated donor HCTs in the first 3 months. Donor type was not associated with differences in OS beyond 3 months after HCT, relapse, disease-free survival, or OS among patients who underwent HCT within 24 months of diagnosis. Patients who experienced graft failure had more advanced disease and commonly used nonmyeloablative conditioning. Although MSD-HCTs were superior, there is no significant difference in HCT outcomes from haploidentical and MUDs. These results establish haploidentical HCT with posttransplantation cyclophosphamide as a viable option in myelofibrosis, especially for ethnic minorities underrepresented in the donor registries.