Donor selection for older leukaemia patients undergoing haematopoietic cell transplant (HCT) is not well defined: outcomes might be improved with a younger offspring donor rather than an older human leukocyte antigen (HLA)-matched sibling donor (MSD). We extended our multicentre dataset. A total of 185 acute leukaemia patients (≥ 50 years) transplanted in first complete remission who received HCT from offspring (n = 62) or MSD (n = 123) were included. A 1:1 ratio matched-pair analysis was performed. We were able to match 54 offspring with 54 MSD patients. Outcomes were compared between the two matched-pair groups. The cumulative incidence of grade II/IV acute graft-versus-host disease (GVHD) (26% vs. 35%; P = 0·23) and chronic GVHD (37% vs. 24%; P = 0·19) was comparable between groups (MSD vs. offspring). The lower three-year transplant-related mortality (9% vs. 26%; P = 0·023) and relapse incidence (6% vs. 17%; P = 0·066) resulted in higher overall survival (85% vs. 58%; P = 0·003) and leukaemia-free survival (LFS) (85% vs. 56%; P = 0·001) in offspring HCT compared with that in MSD HCT. These data might favour a young offspring over an older MSD in patients >50 years. The current analyses confirm that non-HLA donor characteristics, such as kinship and donor age, rather than HLA disparity, predominantly influence survival in older acute leukaemia patients.

中文翻译：

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与老年白血病患者相比，与老年匹配的同胞相比，后代供体移植后存活率提高。

对于接受造血细胞移植（HCT）的老年白血病患者的供体选择尚未明确定义：使用年轻的后代供体而不是匹配人类白细胞抗原（HLA）的同胞供体（MSD）可能会改善结局。我们扩展了多中心数据集。包括总共185例首次完全缓解的急性白血病患者（≥50岁），他们从后代（n = 62）或MSD（n = 123）接受了HCT。进行1：1比例的配对分析。我们能够使54名MSD患者与54名后代相匹配。比较两个配对组的结果。II / IV级急性移植物抗宿主病（GVHD）的累积发生率（26％vs. 35％; P = 0·23）和慢性GVHD（37％vs. 24％; P = 0·19）为组间可比（MSD与后代）。较低的三年移植相关死亡率（9％比26％； P = 0·023）和复发率（6％vs. 17％； P = 0·066）导致更高的总生存率（85％vs。与MSD HCT相比，后代HCT中58％； P = 0.003）和无白血病生存率（LFS）（85％vs. 56％； P = 0.001）。这些数据在年龄大于50岁的患者中可能比年轻的MSD更倾向于年轻的后代。当前的分析证实，非HLA供体的特征（如血缘和供体年龄）而非HLA差异，主要影响老年急性白血病患者的生存。这些数据在年龄大于50岁的患者中可能比年轻的MSD更倾向于年轻的后代。当前的分析证实，非HLA供体的特征（如血缘和供体年龄）而非HLA差异，主要影响老年急性白血病患者的生存。这些数据在年龄大于50岁的患者中可能比年轻的MSD更倾向于年轻的后代。当前的分析证实，非HLA供体的特征（如血缘和供体年龄）而非HLA差异，主要影响老年急性白血病患者的生存。