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For blood or marrow transplant, younger donors more helpful

Older adults with leukemia should get younger, matched donors, if possible

Age50 - 84 years old
Number of Participants4,684
Research GoalImprove Survival
Researchers wondered which type of blood or marrow transplant (BMT) is better at curing acute myeloid leukemia (AML) in patients aged 50 or older. 

Researchers wondered, which matched donor is better? 
  • A younger, unrelated donor, who might have healthier cells, or 
  • A brother or sister, of similar age as the patient, whose cells might be more similar to the patient’s cells? 

Researchers studied about 4,700 patients with AML. The patients got BMT during 2011-2018. All the patients were aged 50 and older. Patients got BMT from a matched donor, from either of 2 groups: 
  • A brother or sister, aged 50-85 (older, sibling donor) 
  • A person who was not a relative, aged 18-35 (younger, unrelated donor) 

About 5 years later, patients were more likely to be free from leukemia if they had a younger, unrelated donor instead of an older, sibling donor. Leukemia came back (relapsed) in: 
  • 35% (35 out of every 100 people) who had a younger, unrelated donor 
  • 41% (41 out of every 100 people) who had an older, sibling donor 

Researchers said a matched unrelated donor aged 18-35 is usually better than a matched sibling donor aged 50 or older. However, if a patient doesn’t have a readily available younger unrelated donor, it’s still helpful to get BMT from a sibling who is older. 

Keep in mind 

This was a real-world study conducted at several medical centers, so patients got different medicines and therapies before and after BMT. Results are not as exact as in clinical trials, where patients all get the same medicines and the only difference is the type of BMT. 

What’s next 

More research is needed as medicines and therapies improve.