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ASH 2025 | Evaluating the impact of donor age on alloSCT outcomes in patients with secondary AML in CR1
Arnon Nagler, MD, Chaim Sheba Medical Center, Tel Aviv, Israel, discusses the impact of donor age on allogeneic stem cell transplantation (alloSCT) outcomes, specifically in the context of secondary acute myeloid leukemia (AML) in first complete remission (CR1). Prof. Nagler notes that, surprisingly, a recent study found no difference in outcomes when using young haploidentical donors under 35 years old versus older matched sibling donors over 35 years old. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
The issue of the age of the patient and the donor becomes an important issue in transplantation. So obviously we know in all transplant data that if the patient is younger, then the results are better. And young is below the age of 25. However, recently there are more and more data that the age of the donor also makes a lot of impact, and usually in many studies we have data that a younger unrelated donor, or a younger haploidentical donor, is better than an older sibling donor, most probably because of the immunocompetence of the immune system and the T-cell repertoire is broader...
The issue of the age of the patient and the donor becomes an important issue in transplantation. So obviously we know in all transplant data that if the patient is younger, then the results are better. And young is below the age of 25. However, recently there are more and more data that the age of the donor also makes a lot of impact, and usually in many studies we have data that a younger unrelated donor, or a younger haploidentical donor, is better than an older sibling donor, most probably because of the immunocompetence of the immune system and the T-cell repertoire is broader.
And so we published this year a paper about looking at young or older alternative donors like haplo-mismatched unrelated donors for patients with AML and this time we looked at the young haplo, so below the age of 35, compared to old siblings above 35 for patients with secondary AML and secondary AML is a distinct type of AML with a bad prognosis. And actually we didn’t find any difference. I mean we were both a bit disappointed but it was surprising that there was no difference or no advantage of young haplo donors below the age of 35 to old sibling donors above the age of 35 in almost all the outcome parameters.
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