DefinePK

Abstract

Objective: To evaluate the impact of donor age on outcomes of matched sibling donor haemopoietic stem cell transplant (HSCT).
Study design: Descriptive cross-sectional study
Settings: Tertiary care bone marrow transplant centre Rawalpindi from Jan 2023 to Dec 2024.
Methods: The study included 85 adult patients who met the inclusion criteria and underwent matched sibling donor hematopoietic stem cell transplantation (MSD-HSCT) for both malignant and non-malignant hematological disorders. Prior to transplantation, informed consent was obtained from all patients and donors. The study evaluated the influence of donor age on neutrophil and platelet engraftment, graft-versus-host disease (GVHD), and survival outcomes. All statistical analyses were conducted using SPSS version 25.0.
Results: The mean recipient age was 28.25±9.72 years. Aplastic anemia (42.4%), followed by AML (25.9%) and ALL (23.5%) were among the most frequent indications of transplant. Mean donor age was 29.4±12.5 years and 71.8% were male. The most common donor relation with patients was sibling donor (96.5%). Majority of recipients underwent allogeneic HSCT 69(81.2%) and 54(63.5%) had no ABO mismatch. HSCT from donors <30 years of age had early neutrophils and platelets engraftment, less chronic GVHD and better survival statistics compared to HSCT from donors > 30 years of age.
Conclusion: In our study, recipients of sibling-donor HSCTs with donors under 30 years of age experienced lower rates of chronic GVHD, faster platelet engraftment (P?=?0.02), and there was a trend toward improvement in OS, DFS, and GRFS, although the latter outcomes were not statistically significant. Other than platelet engraftment, there was no notable difference in neutrophil engraftment, GVHD incidence, or survival metrics. Patients experiencing acute GVHD showed significantly worse OS and DFS compared to those without aGVHD.
Keywords: Hematopoietic and stem cell transplantation (HSCT), Donor age, Engraftment, Overall survival (OS)