There is a paucity of information to guide the selection of the most suitable donor in haploidentical (Haplo) hematopoietic stem cell transplantation (HSCT). For this reason, from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, we conducted a retrospective analysis to evaluate the impact of Haplo donor characteristics on outcomes in patients with acute myeloid leukemia (AML) who received graft-versus-host disease prophylaxis with posttransplant cyclophosphamide (PTCy). The primary end point was graft-versus-host disease (GVHD)-free and relapse-free survival (GRFS). Overall, 2200 patients were included. The median age of donors was 37 years (range, 8-71); 820 (37%) were females, including 458 (21%) who were used for male recipients. In addition, 1631 donors (74%) donated peripheral blood (PB). Multivariable analysis identified certain donor-related risk factors with a detrimental impact on transplant outcomes. The use of PB, older donors' ages (>37 years), and female donors to male recipients negatively affected GRFS. Donor's age and female donor-to-male recipient combination also affected nonrelapse mortality, leukemia-free survival, and overall survival. In conclusion, donor-related variables significantly influence outcomes in patients with AML after Haplo-HSCT with PTCy. When possible, younger donors and male donors for male recipients should be prioritized. The use of bone marrow can additionally prevent GVHD.

Azienda Ospedaliero Universitaria di Udine Udine Italy

Blood and Marrow Transplant Unit Saint Louis Hospital Paris France

Bone Marrow Transplantation Program Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon

CIBERONC Carlos 3 Health Institute Madrid Spain

Departament de Medicina Universitat de València València Espanya

Department of Bone Marrow Transplantation and Oncohematology Maria Sklodowska Curie National Research Institute of Oncology Gliwice Poland

Department of Hematology and Cellular Therapy CHU Bordeaux Bordeaux France

Department of Internal Medicine Bone Marrow Transplantation Unit University Hospital of Patras Patras Greece

Division of Hematology and Bone Marrow Transplantation Chaim Sheba Medical Center Ramat Gan Israel

EBMT Paris Office Hospital Saint Antoine Paris France

Grosshadern Clinic Munich Germany

Hematology and Bone Marrow Transplant Unit San Raffaele Scientific Institute IRCCS Milano Italy

Hematology Department La Fe University and Polytechnic Hospital Valencia Spain

Hospital Saint Antoine Sorbonne University Paris France

Humanitas Research Hospital Milano Italy

Institute of Hematology and Blood Transfusion Prague Czech Republic

IRCCS Ospedale Policlinico San Martino Genova Italy

Medicana International Hospital Istanbul Istanbul Turkey

Pediatric Hematology Oncology Fondazione IRCCS Policlinico San Matteo Pavia Italy

S S Trapianto di Cellule Staminali Torino Italy

Transplantation and Cellular Therapy Program Marseille France

Turku University Hospital Turku Finland

University Hospital Eppendorf Hamburg Germany

University Hospital of Nantes Nantes France

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