Comparative Assessment of Long-Term Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation from Unrelated Donors Registered in the Russian and International Databases for Hematologic Diseases

BACKGROUND. In recent years, the number of allogeneic hematopoietic stem cell transplantations (allo-HSCT) has continued to rise due to the ongoing improvement of transplantation technologies and rapid growth of bone marrow donor registries. Clinical outcomes of allo-HSCT depend on many factors including ethnic matching of patients and donors. There is evidence on a higher efficacy of allo-HSCT from the national registry donors compared with the donors from international registries.

AIM. To assess the efficacy of allo-HSCT from the Russian and foreign donors.

MATERIALS & METHODS. This retrospective clinical study enrolled 585 patients with various hematologic diseases. In the RM Gorbacheva Research Institute, in the period from 2010 to 2019, all patients received allo-HSCT from 9/10 or 10/10 HLA-matched unrelated donors from the Russian (n = 141) and international (n = 444) registries. In the early post-transplant period, cyclophosphamide was administered to all patients to prevent the graft-versus-host disease (GVHD). Paired analysis was carried out in two groups of patients formed and balanced according to the following criteria: age, disease variant, conditioning regimen intensity, graft source, the number of allo-HSCT recipients out of remission, and the year of transplantation. The median follow-up in the total group was 17 months (range 1–74 months).

RESULTS. The outcomes of allo-HSCT from the Russian and international donors appeared to be compatible: the 5-year overall survival was 64 % and 62 %, respectively (p = 0.19), the 5-year event-free survival was 57 % and 43 % (p = 0.14), the transplant mortality was 17 % and 18 % (p = 0.62), and the cumulative relapse incidence was 12 % and 20 %, respectively (p = 0.08). The paired analysis yielded similar results in both groups for all the above mentioned end points. The risks of acute as well as chronic GVHD appeared to be the same.

CONCLUSION. The long-terms outcomes of allo-HSCT from the Russian and foreign donors proved to be compatible. Further development of the Federal Bone Marrow Donor Registry will provide availability and affordability of allo-HSCT for more citizens of the Russian Federation. This remains an issue of current concern because of the challenges of logistics, financing, and a longer interval between the donor search through international registries and allo-HSCT performance.

• Anastasiya Viktorovna Beynarovich RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-2952-513X (unauthenticated)
• A.L. Alyanskii RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0003-3910-6972 (unauthenticated)
• K.S. Afanaseva RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-2953-4300 (unauthenticated)
• L.V. Fedorova RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-3275-219X (unauthenticated)
• A.M. Chekalov RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-4923-6773 (unauthenticated)
• E.A. Bakin RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-5694-4348 (unauthenticated)
• N.E. Ivanova RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0009-0006-5455-860X (unauthenticated)
• A.A. Golovacheva RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022
• E.V. Babenko RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-1959-9063 (unauthenticated)
• M.A. Estrina RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-1259-8885 (unauthenticated)
• O.G. Smykova RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0009-0004-5604-0666 (unauthenticated)
• Yu.Yu. Vlasova RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-7762-0107 (unauthenticated)
• E.V. Morozova RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-9605-485X (unauthenticated)
• N.B. Mikhailova RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-8153-8122 (unauthenticated)
• A.G. Smirnova RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-2814-7683 (unauthenticated)
• S.N. Bondarenko RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-2446-8092 (unauthenticated)
• M.D. Vladovskaya RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022
• D.E. Pevtsov RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022
• A.A. Vitrishchak RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022
• I.S. Moiseev RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-4332-0114 (unauthenticated)
• A.D. Kulagin RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-9589-4136 (unauthenticated)
• L.S. Zubarovskaya RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0003-2594-7703 (unauthenticated)
• B.V. Afanasyev RM Gorbacheva Research Institute, Pavlov University, 6/8 L’va Tolstogo ul., Saint Petersburg, Russian Federation, 197022 https://orcid.org/0000-0002-1235-4530 (unauthenticated)

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