Alternative donors: a match for matched sibling donors?
Menée à partir de données portant sur 106 188 patients atteints d'une tumeur hématologique et ayant reçu une première greffe allogénique de cellules souches hématopoïétiques entre 2001 et 2015, cette étude européenne rétrospective analyse l'évolution de différents indicateurs associés à la survie (survie globale, récidive, survie sans progression, survenue d'une réaction chronique ou aiguë du greffon contre l'hôte, etc.), en fonction du type de donneur (donneur apparenté ou non, donneur haplo-identique, sang de cordon ombilical, etc.) et de la période de la greffe (2001-2005, 2006-2010 et 2011-2015)
Allogeneic haematopoietic stem cell transplantation (HCST) is a curative treatment for haematological malignancies. Finding a suitable donor is one of the most important steps for patients who undergo allogeneic HSCT. HLA-matched sibling donors are considered ideal, but availability of such a donor is limited to less than 30% of patients. Most patients therefore need to find other suitable donors. Advances in HLA typing technology, graft-versus-host-disease (GVHD) prophylaxis, and management of complications have substantially reduced the risk of non-relapse mortality across the world, and HSCT from an alternative donor has been found to be increasingly safe and feasible. The hope is that outcomes of HSCT from alternative donors such as HLA-matched unrelated donors, haploidentical donors, and umbilical cord blood donors are catching up with those of HSCT from HLA-matched sibling donors, but this question has not been addressed rigorously in a large contemporary cohort of HSCT.