The Effect of Donor Age on Outcome after Allogeneic Hematopoietic Stem Cell Transplantation

Background The age of patients admitted to HSCT is increasing. The median age of adult patients is close to 60 years at many centers. With a sibling donor this means that in most cases an older donor will be used. There are reports that donor age is important for the outcome. Hypothesis Our hypothesis is that it may be better to select a young well matched (10/10 match) unrelated donor (MUD), if available, instead of an older matched related donor (MRD). Material In a homogenous material consisting of patients with myeloid malignancies (AML, MDS, MPN, CML) receiving a PBSC graft and myeloablative conditioning, CsA+MTX as GVHD prophylaxis without in vivoT-cell depletion (no ATG), we studied the effect of the donor age. For this reason we selected patients with a MRD and an older donor (≥40y) and a 10/10 MUD with a younger donor ( 60y (n=12). In the MUD group donor age groups were: 18-25y (n=22) and 26-39y (n=38) (table 1). Results The best OS, RFS, TRM and GRFS were seen in the “MUD age 18-25y” group (Figure 1). No effect was seen on incidence of relapse and acute and chronic GVHD. In multivariate analysis, corrected for differences between the groups, we found that OS, RFS, TRM and GRFS were better in the “MUD age 18-25y” group, compared to the MRD groups (figure 1). Conclusion In cases where an older sibling donor is available, it may be reasonable to search for a well-matched young (