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Meta-analysis reports 53% 2-year overall survival after haploidentical HSCT in older adultsStudy reviews survival rates for older adults after haploidentical stem cell transplants

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Key Takeaway
Interpret pooled haploidentical HSCT survival data in older adults with caution due to significant outcome heterogeneity.

This systematic review and meta-analysis pooled data from 16 studies (18 cohorts) involving 1,268 adults aged 60 years or older with hematologic malignancies who underwent haploidentical hematopoietic stem cell transplantation (HSCT). The analysis examined survival outcomes without a direct comparator group, focusing on pooled estimates from observational studies.

The primary outcome was overall survival (OS) at 1, 2, and 3 years. Pooled 1-year OS was 62% (95% CI, 56–68%), 2-year OS was 53% (95% CI, 46–60%), and 3-year OS was 45% (95% CI, 38–52%). Secondary outcomes included 3-year non-relapse mortality of 28% (95% CI, 23–34%) and 3-year relapse incidence of 32% (95% CI, 25–40%). Safety and tolerability data were not reported in the meta-analysis.

Key limitations include significant statistical heterogeneity across studies (I² = 71–82%), indicating substantial variability in reported outcomes. A composite risk score explained 39–60% of between-study variability, but this score has not been validated as a predictive tool. The analysis includes only observational data, which cannot establish causation. These findings suggest haploidentical HSCT may be feasible in selected older patients, but outcomes vary considerably across centers and patient populations.

Researchers conducted a systematic review and meta-analysis to understand survival outcomes for older adults with blood cancers who received haploidentical hematopoietic stem cell transplants (HSCT). This type of transplant uses stem cells from a partially matched donor, often a family member. The analysis combined data from 16 studies involving 1,268 patients aged 60 and older.

The review found that the pooled two-year overall survival rate was 53%, meaning just over half of patients were alive two years after transplant. The three-year survival rate was 45%. At three years, about 28% of patients had died from causes other than cancer returning, and about 32% experienced a relapse of their cancer.

It's important to note that survival outcomes varied significantly between different studies included in this review. The two-year survival rates ranged from as low as 15% to as high as 74% across different research centers. This substantial variation means the average numbers may not predict what any individual patient might experience.

This analysis combines existing observational studies and cannot determine whether this transplant approach causes better or worse outcomes compared to other treatments. The results provide a broad picture of what has been reported in the literature, but patients should discuss their specific situation with their medical team when considering treatment options.

What this means for you:
Review shows varied survival rates for older adults after haploidentical transplants; outcomes differ widely between studies.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMar 2026
View Original Abstract ↓
BackgroundHaploidentical hematopoietic stem cell transplantation (HSCT) has become a viable option for older adults with hematologic malignancies lacking matched donors. However, outcomes in patients aged ≥60 years vary widely, with reported 2-year overall survival (OS) ranging from 15% to 74%. This systematic review and meta-analysis aimed to estimate pooled survival outcomes and identify factors contributing to outcome heterogeneity in older recipients of haploidentical HSCT.MethodsA comprehensive systematic literature search was conducted across PubMed, Google Scholar, and Cochrane databases from inception to April 30, 2025, following PRISMA guidelines. Studies enrolling adults aged ≥60 years undergoing haploidentical HSCT with reported OS, non-relapse mortality (NRM), or relapse incidence at 1-, 2-, or 3-years were included. Meta-analyses were performed using DerSimonian-Laird random-effects models. A composite “High-Impact Trio” risk score was developed based on the prevalence of active/refractory disease, high-risk cytogenetics, and impaired performance status to explore heterogeneity through subgroup analyses and meta-regression.ResultsSixteen studies (18 cohorts; 1,268 patients) were analyzed. Pooled survival estimates were: 1-year OS 62% (95% CI, 56–68%), 2-year OS 53% (95% CI, 46–60%), and 3-year OS 45% (95% CI, 38–52%). Three-year NRM and relapse incidence were 28% (95% CI, 23–34%) and 32% (95% CI, 25–40%), respectively. Significant heterogeneity was observed (I² = 71–82%); the risk score explained 39–60% of between-study variability and correlated with OS and NRM (P
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