{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T06:19:47Z","timestamp":1782973187615,"version":"3.54.5"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>This study evaluated the impact of donor age on clinical outcomes in 274 patients with acute myeloid leukemia (AML) haplo-HCT using PTCY-based prophylaxis. Median patient age was 53 years, with 42.6% classified as high-risk AML. The median donor age of 38 years; 31% were under 30. An optimal donor age cut-off of 30 years was identified through ROC analysis. Patients receiving grafts from younger donors (&amp;lt;30 years) showed lower rates of aGVHD grade II\u2013IV (3.0% vs. 19.9%, p &amp;lt; 0.001) and grade III\u2013IV (1.5% vs. 10.2%, p = 0.034), with no differences in cGVHD or relapse rates. Overall survival (OS) was higher in the younger donor group (2-year: 80.6% vs. 64.3%, p = 0.011), along by lower non-relapse mortality (NRM) (2-year: 11.1% vs. 23.2%, p = 0.031). Multivariate analysis confirmed donor age \u226530 years as an independent adverse factor for OS (HR: 1.88, p = 0.019) and NRM (HR: 2.06, p = 0.049), along with older recipient age, higher HCT-CI score, and high-risk AML. These findings suggest that younger donor age contributes to improved survival, primarily through reduced NRM and aGVHD, supporting prioritization of younger donors when multiple haploidentical options are available to optimize transplant outcomes.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1700463","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:15:16Z","timestamp":1764306916000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Donor age as an independent predictor of inferior outcomes after haploidentical hematopoietic cell transplantation in acute myeloid leukemia. Study conducted on behalf of GETH-TC"],"prefix":"10.3389","volume":"16","author":[{"given":"Daniel","family":"Mun\u00e1rriz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"P\u00e9rez-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Mart\u00edn Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Luque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Esquirol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Mart\u00edn","family":"Calvo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Aparicio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Pe\u00f1a-Mu\u00f1\u00f3z","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inmaculada","family":"Heras Fernando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itziar","family":"Oiartzabal Ormtegi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo Jes\u00fas","family":"S\u00e1ez Mar\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Fern\u00e1ndez-Luis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jos\u00e9","family":"Dom\u00ednguez-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Villar Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"L\u00f3pez-Lorenzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Acosta Fleitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Pilar","family":"Gonz\u00e1lez-Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Torrado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Filaferro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascual","family":"Balsalobre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jes\u00fas","family":"Pascual Cascon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Rovira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Queralt Salas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"101466","DOI":"10.1016\/j.beha.2023.101466","article-title":"Allogeneic hematopoietic cell transplantation in acute myeloid leukemia","volume":"36","author":"Magee","year":"2023","journal-title":"Best Pract Res Clin Haematol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2019.07.028","article-title":"Haploidentical transplantation with post-transplant cyclophosphamide versus unrelated donor hematopoietic stem cell transplantation: A systematic review and meta-analysis","volume":"25","author":"Arcuri","year":"2019","journal-title":"Biol Blood Marrow Transplant J Am Soc Blood Marrow Transpl"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.01.013","article-title":"Selecting the best donor for haploidentical transplant: impact of HLA, killer cell immunoglobulin-like receptor genotyping, and other clinical variables","volume":"24","author":"Solomon","year":"2018","journal-title":"Biol Blood Marrow Transplant J Am Soc Blood Marrow Transpl"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2023.06.020","article-title":"Impact of donor age on allogeneic hematopoietic cell transplantation outcomes in older adults with acute myeloid leukemia","volume":"29","author":"Abid","year":"2023","journal-title":"Transplant Cell Ther"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.7.2043","article-title":"Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age","volume":"98","author":"Kollman","year":"2001","journal-title":"Blood"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-024-02359-8","article-title":"Older MRD vs. younger MUD in patients older than 50 years with AML in remission using post-transplant cyclophosphamide","volume":"38","author":"Piemontese","year":"2024","journal-title":"Leukemia"},{"key":"B7","doi-asserted-by":"publisher","first-page":"687.e1","DOI":"10.1016\/j.jtct.2024.05.001","article-title":"Comparison of older related versus younger unrelated donors for older recipients of allogeneic hematopoietic cell transplantation with acute myeloid leukemia or myelodysplastic syndrome: A large single-center analysis","volume":"30","author":"Kim","year":"2024","journal-title":"Transplant Cell Ther Off Publ Am Soc Transplant Cell Ther"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2017.34","article-title":"Use of haploidentical stem cell transplantation continues to increase: the 2015 European Society for Blood and Marrow Transplant activity survey report","volume":"52","author":"Passweg","year":"2017","journal-title":"Bone Marrow Transpl"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-025-02524-2","article-title":"The 2023 EBMT report on hematopoietic cell transplantation and cellular therapies. Increased use of allogeneic HCT for myeloid Malignancies and of CAR-T at the expense of autologous HCT","volume":"60","author":"Passweg","year":"2025","journal-title":"Bone Marrow Transpl"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.6004\/jadpro.2023.14.6.5","article-title":"Post-transplant cyclophosphamide for the prevention of graft-vs.-host disease in allogeneic hematopoietic cell transplantation: A guide to management for the advanced practitioner","volume":"14","author":"Kachur","year":"2023","journal-title":"J Adv Pract Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023023697","article-title":"Younger unrelated donors may be preferable over HLA match in the PTCy era: a study from the ALWP of the EBMT","volume":"143","author":"Sanz","year":"2024","journal-title":"Blood"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27681","article-title":"Better outcome following younger haploidentical donor versus older matched unrelated donor transplant for fit patients with acute myeloid leukemia transplanted in first remission: A study from the global committee and the acute leukemia working party of the EBMT","volume":"100","author":"Ye","year":"2025","journal-title":"Am J Hematol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003922","article-title":"Relationship of donor age and relationship to outcomes of haploidentical transplantation with posttransplant cyclophosphamide","volume":"5","author":"DeZern","year":"2021","journal-title":"Blood Adv"},{"key":"B14","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/j.bbmt.2018.11.004","article-title":"Effect of aging and predonation comorbidities on the related peripheral blood stem cell donor experience: report from the related donor safety study","volume":"25","author":"Pulsipher","year":"2019","journal-title":"Biol Blood Marrow Transplant J Am Soc Blood Marrow Transpl"},{"key":"B15","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3324\/haematol.2015.139105","article-title":"Risk factors for relapse after allogeneic transplantation in acute myeloid leukemia","volume":"101","author":"Ossenkoppele","year":"2016","journal-title":"Haematologica"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-06-746412","article-title":"Aging of hematopoietic stem cells","volume":"131","author":"De Haan","year":"2018","journal-title":"Blood"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2024.285392","article-title":"Clinical impact of clonal hematopoiesis in hematopoietic cell transplantation: a review, meta-analysis, and call to action","volume":"109","author":"Gillis","year":"2024","journal-title":"Haematologica"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.674093","article-title":"Immune reconstitution in the aging host: opportunities for mechanism-based therapy in allogeneic hematopoietic cell transplantation","volume":"12","author":"Lin","year":"2021","journal-title":"Front Immunol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcyt.2021.10.011","article-title":"Presence of innate lymphoid cells in allogeneic hematopoietic grafts correlates with reduced graft-versus-host disease","volume":"24","author":"Kroeze","year":"2022","journal-title":"Cytotherapy"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-025-02580-8","article-title":"The impact of ABO compatibility on allogeneic hematopoietic cell transplantation outcomes: a contemporary and comprehensive study from the transplant complications working party of the EBMT","volume":"60","author":"G\u00fcven","year":"2025","journal-title":"Bone Marrow Transpl"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1700463\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:15:16Z","timestamp":1764306916000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1700463\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":20,"alternative-id":["10.3389\/fimmu.2025.1700463"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1700463","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]},"article-number":"1700463"}}