Study points to broader stem cell donor options for blood cancer patients
For decades, stem cell transplantation has operated under a simple rule: The closer the donor match, the better. Patients with leukemia, lymphoma, myelodysplastic syndromes and other blood cancers often faced an extensive search for a donor whose immune system markers aligned as closely as possible with their own.
Decades of stem cell transplantation have been guided by the principle that a closer donor match leads to better outcomes. However, a groundbreaking study in Blood Advances challenges this long-held belief. Researchers found that patients who received stem cell transplants from younger, more genetically mismatched unrelated donors, despite having less than ideal HLA matches, experienced favorable results.
These transplants, made possible by a process called PTCy, which selectively eliminates highly reactive immune cells, helped to reduce the risk of severe graft-versus-host disease (GVHD). The study, led by Dr. Antonio Martin Jimenez, analyzed outcomes from the ACCESS trial and found that one year after transplantation, overall survival was higher among recipients of mismatched donor grafts, reaching 85.6% compared to 78.6% for recipients of more closely matched donors.
Severe GVHD, relapse, and non-relapse mortality remained relatively low in both groups. This shift in donor selection criteria opens up new possibilities for patients who previously had limited options due to a lack of suitable donor matches.
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