期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 17, 期 5, 页码 640-648出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2010.07.022
关键词
HLA match; Allogeneic transplantation; Acute myelogenous leukemia; Acute lymphoblastic leukemia
资金
- Public Health Service from National Cancer Institute (NCI) [U24-CA76518]
- National Heart, Lung and Blood Institute (NHLBI)
- National Institute of Allergy and Infectious Diseases (MAID)
- NHLBI/NCI [5U01HL069294]
- Health Resources and Services Administration [HHSH2342006 37015C]
- Office of Naval Research [N00014-06-1-0704, N00014-08-1-0058]
- AABB
- Aetna
- American Society for Blood and Marrow Transplantation
- Amgen
- Astellas Pharma US
- Baxter International
- Bayer HealthCare Pharmaceuticals
- Be the Match Foundation
- Biogen IDEC
- BioMarin Pharmaceutical
- Biovitrum AB
- Blood Center of Wisconsin
- Blue Cross and Blue Shield Association
- Bone Marrow Foundation
- Canadian Blood and Marrow Transplant Group
- Caridian BCT
- Celgene
- CellGenix
- Centers for Disease Control and Prevention
- Children's Leukemia Research Association
- ClinImmune Labs
- CTI Clinical Trial and Consulting Services
- Cubist Pharmaceuticals
- Cylex
- CytoTherm
- DOR BioPharma
- Dynal Biotech (an Invitrogen Company)
- Eisai
- Enzon Pharmaceuticals
- European Group for Blood and Marrow Transplantation
- Gamida Cell
- GE Healthcare
- Genentech
- Genzyme
- Histogenetics
- HKS Medical Information Systems
- Hospira
- Infectious Diseases Society of America
- Kiadis Pharma
- Kirin Brewery Co
- Leukemia & Lymphoma Society
- Merck Company
- Medical College of Wisconsin
- MGI Pharma
- Michigan Community Blood Centers
- Millennium Pharmaceuticals
- Miller Pharmacal Group
- Milliman USA
- Miltenyi Biotec
- National Marrow Donor Program
- Nature Publishing Group
- New York Blood Center
- Novartis Oncology
- Oncology Nursing Society
- Osiris Therapeutics
- Otsuka America Pharmaceutical
- Pall Life Sciences
- PDL BioPharma
- Pfizer
- Pharmion
- Saladax Biomedical
- Schering
- Society for Healthcare Epidemiology of America
- StemCyte
- StemSoft Software
- Sysmex America
- Teva Pharmaceutical Industries
- THERAKOS
- Thermogenesis
- Vidacare
- Vion Pharmaceuticals
- ViraCor Laboratories
- ViroPharma
- Wellpoint
Approximately 13% of patients lacking an HLA-identical sibling have a one-antigen mismatched related donor (MMRD). Historically, outcomes from the use of a one-antigen MMRD were considered equivalent to those from the use of a matched unrelated donor (UD). Recent improvements in UD stem cell transplantation (SCT) resulting from better molecular HLA matching justifies investigating whether UD should be preferred over MMRD in adult patients with acute leukemia. Here, we compared the outcomes of MMRD (n = 89) and HLA-A, -B, -C, and -DRB1 allele matched UD (n = 700) SCT reported to the Center for International Blood and Marrow Transplant Research between 1995 and 2005. The patients underwent transplantation for acute myelogenous leukemia or acute lymphoblastic leukemia in first or second complete remission. Donor type was not associated with hematologic recovery. Univariate and multivariate comparisons of MMRD versus HLA-matched UD transplants showed no statistically significant differences in overall survival, disease-free survival, treatment-related mortality, relapse, or 100-day grade III-IV acute graft-versus-host disease (GVHD). MMRD SCT was associated with a lower rate of chronic GVHD at 1 year (35% vs 47%; P = .03), which was confirmed by multivariate analysis (relative risk, 0.58; 95% confidence interval, 0.39-0.85; P<.01). According to our data, HLA-matched UD and MMRD SCT are associated with comparable survival. Given that less chronic GVHD was observed in the MMRD transplantations, this option, when available, remains the first choice in patients with acute leukemia without an HLA-identical sibling in need of allogeneic SCT. Biol Blood Marrow Transplant 17: 640-648 (2011) (C) 2011 American Society for Blood and Marrow Transplantation
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