Dr Jain on the Use of Haploidentical Donors in Myelofibrosis

Tania Jain, MBBS, director, Adult Chimeric Antigen Receptor T-cell Therapy Program for Hematological Malignancies, Sidney Kimmel Comprehensive Cancer Center, assistant professor of oncology, Johns Hopkins Medicine, discusses the use of haploidentical donors (HD) in myelofibrosis.

At the 2023 Transplantation and Cellular Therapy Meetings, investigators presented blood and marrow transplant outcomes with haploidentical and unrelated donor types in myelofibrosis. The aim of the study presented by Jain et al was to determine how haploidentical donors compare with other forms of donor selection for allogeneic transplant.

Results from a prior multicenter study demonstrated that the use of haploidentical donors was associated with an overall survival (OS) rate of 72% at 3 years, Jain explains, adding that this was a time when people were skeptical of haploidentical grafts and how it would fare against patient splenomegaly, Jain notes.

The present study used registry data from CIBMTR to provide a better comparison of donor types, Jain notes. Investigators compared all 4 donor types: matched sibling donor, matched unrelated donor, mismatched unrelated donor, and haploidentical donors with post-transplant cyclophosphamide and their outcomes in patients with myelofibrosis following transplant, Jain continues.

Investigators showed that matched sibling donors were associated with better OS compared with the other 3 donor options. However, within haploidentical donors, matched unrelated donors, and mismatched unrelated donors, there were no significant differences in OS, Jain expands. This is different compared with what the registry data showed over 10 years ago, Jain notes. This speaks to the progress that the transplant platforms, transplant treatments, and supportive management have done over the past decade, Jain concludes.