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News
Good news for leukemia patients without a perfect donor match. A phase 2 trial found that myeloid leukemia patients who received stem cell transplants from 6/8 HLA-mismatched unrelated donors achieved strong 1-year survival rates — comparable to those with better-matched donors. The findings suggest that carefully selected mismatched donors, paired with a standardized GVHD prevention regimen, can be a viable transplant option.
Finding a perfectly matched stem cell donor is a major hurdle for many leukemia patients — but new data suggest a less-than-perfect match may still deliver strong outcomes. The phase 2 ACCESS trial enrolled 268 adults with acute or chronic myeloid leukemia undergoing their first allogeneic stem cell transplant, comparing outcomes between patients who received grafts from 7/8 versus 6/8 (or lower) HLA-matched unrelated donors. All patients received a uniform post-transplant cyclophosphamide (PTCy)-based regimen to prevent graft-vs-host disease (GVHD).
The results were encouraging: 1-year overall survival was slightly higher in the 6/8 match group (85.6%) compared to the 7/8 group (78.6%), and 1-year progression-free survival was nearly identical in both groups (~69%). Rates of severe acute and chronic GVHD were also comparable or slightly lower in the 6/8 group. Researchers cautioned, however, that these findings are descriptive and should not be interpreted as establishing equivalence with 7/8 MMUD transplantation.
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Why it matters: For patients who lack a well-matched donor — a disproportionate challenge for racial and ethnic minorities — these findings offer a meaningful path forward. Expanding the eligible donor pool to include 6/8-matched donors, with the right GVHD prophylaxis, could make life-saving transplants accessible to more patients.
