Donor matters: Donor selection impact on hematopoietic stem cell transplantation outcomes in Hispanic patients with B-cell acute lymphocytic leukemia: Insights from a myeloablative HSCT study

Karam Ashouri; Anush A Ginosyan; Mollee Chu; Brian Hom; Jennifer Hwang; Karen Resnick; Yekta Rahimi; Preet Chaudhary; Karrune Woan; Imran Siddiqi; Abdullah Ladha; Amir Ali; Eric Leon Tam; George Yaghmour

doi:10.1016/j.leukres.2024.107501

Donor matters: Donor selection impact on hematopoietic stem cell transplantation outcomes in Hispanic patients with B-cell acute lymphocytic leukemia: Insights from a myeloablative HSCT study

Leuk Res. 2024 Apr 12:141:107501. doi: 10.1016/j.leukres.2024.107501. Online ahead of print.

Authors

Affiliations

¹ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
² Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
³ Division of Pathology, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
⁴ Department of Pharmacy, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
⁵ Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, USA. Electronic address: george.yaghmour@med.usc.edu.

PMID: 38631149
DOI: 10.1016/j.leukres.2024.107501

Abstract

Background: Hematopoietic stem cell transplantation (HSCT) is a pivotal treatment for high-risk acute lymphocytic leukemia (ALL), although limited by suitable human leukocyte antigen (HLA)-matched sibling donors (MSD). This study evaluates the impact of donor selection on outcomes in post-HSCT Hispanic B-cell ALL patients.

Methodology: This single-center retrospective study evaluates outcomes in 88 adult Hispanic B-cell ALL patients who underwent haploidentical, MSD, or MUD myeloablative HSCT between 2013 and 2023.

Results: Compared to Haploidentical transplants, MSD exhibited worse cumulative incidence of relapse (CIR) (HR = 3.39; P = 0.014) and disease-free survival (DFS) (HR = 2.44; P = 0.048) whereas MUD outcomes did not differ. This effect persisted even when controlling for pre-HSCT stage and Minimal residual disease (MRD) status. In addition, Ph-like was a significant predictor of worse DFS (HR = 3.60; P=0.014) and CIR (HR = 2.97; P=0.035) on multivariate analysis. Older donor age correlated with worse GVHD-free, relapse-free survival (GRFS) in haploidentical transplants (HR = 1.05; P=0.036).

Conclusion: Our data highlights improved outcomes with younger, haploidentical donors among Hispanic B-cell ALL patients undergoing myeloablative HSCT. This underscores the importance of donor selection in optimizing outcomes for ALL patients.

Keywords: Acute lymphocytic leukemia; Disease-free survival; Ethnic disparities; Graft-versus-host disease; Haploidentical donors; Hematopoietic stem cell transplantation.