期刊
BLOOD
卷 116, 期 19, 页码 4007-4015出版社
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2010-01-261958
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资金
- National Cancer Institute (NCI) [5U01HL069294]
- National Heart, Lung, and Blood Institute (NHLBI) [5U01HL069294]
- National Institute of Allergy and Infectious Diseases (NIAID) [U24-CA76518]
- Health Resources and Services Administration (HRSA/DHHS) [HHSH234200637015C]
- Office of Naval Research [N00014-06-1-0704, N00014-08-1-0058]
- AABB
- Aetna
- American Society for Blood and Marrow Transplantation
- Amgen Inc
- Medical College of Wisconsin
- Astellas Pharma US Inc
- Baxter International Inc
- Bayer HealthCare Pharmaceuticals
- Be the Match Foundation
- Biogen IDEC
- BioMarin Pharmaceutical Inc
- Biovitrum AB
- BloodCenter of Wisconsin
- Blue Cross and Blue Shield Association
- Bone Marrow Foundation
- Canadian Blood and Marrow Transplant Group
- CaridianBCT
- Celgene Corporation
- CellGenix GmbH
- Centers for Disease Control and Prevention
- Children's Leukemia Research Association
- ClinImmune Labs
- CTI Clinical Trial and Consulting Services
- Cubist Pharmaceuticals
- Cylex Inc
- CytoTherm
- DOR BioPharma Inc
- Dynal Biotech
- Eisai Inc
- Enzon Pharmaceuticals Inc
- European Group for Blood and Marrow Transplantation
- Gamida Cell Ltd
- GE Healthcare
- Genentech Inc
- Genzyme Corporation
- Histogenetics Inc
- HKS Medical Information Systems
- Hospira Inc
- Infectious Diseases Society of America
- Kiadis Pharma
- Kirin Brewery Co Ltd
- Leukemia & Lymphoma Society
- Merck Company
- MGI Pharma Inc
- Michigan Community Blood Centers
- Millennium Pharmaceuticals Inc
- Miller Pharmacal Group
- Milliman USA Inc
- Miltenyi Biotec Inc
- National Marrow Donor Program
- Nature Publishing Group
- New York Blood Center
- Novartis Oncology
- Oncology Nursing Society
- Osiris Therapeutics Inc
- Otsuka America Pharmaceutical Inc
- Pall Life Sciences
- Pfizer Inc
- Saladax Biomedical Inc
- Schering Corporation
- Society for Healthcare Epidemiology of America
- Soligenix Inc
- StemCyte Inc
- StemSoft Software Inc
- Sysmex America Inc
- THERAKOS Inc
- Thermogenesis Corporation
- Vidacare Corporation
- Vion Pharmaceuticals Inc
- ViraCor Laboratories
- ViroPharma Inc
- Wellpoint Inc.
Although some trials have allowed matched or single human leukocyte antigen (HLA)-mismatched related donors (mmRDs) along with HLA-matched sibling donors (MSDs) for pediatric bone marrow transplantation in early-stage hematologic malignancies, whether mmRD grafts lead to similar outcomes is not known. We compared patients < 18 years old reported to the Center for International Blood and Marrow Transplant Research with acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, and myelodysplastic syndrome undergoing allogeneic T-replete, myeloablative bone marrow transplantation between 1993 and 2006. In total, patients receiving bone marrow from 1208 MSDs, 266 8/8 allelic-matched unrelated donors (URDs), and 151 0-1 HLA-antigen mmRDs were studied. Multivariate analysis showed that recipients of MSD transplants had less transplantation-related mortality, acute graft-versus-host disease (GVHD), and chronic GVHD, along with better disease-free and overall survival than the URD and mmRD groups. No differences were observed in transplant-related mortality, acute and chronic GVHD, relapse, disease-free survival, or overall survival between the mmRD and URD groups. These data show that mmRD and 8/8 URD outcomes are similar, whereas MSD outcomes are superior to the other 2 sources. Whether allele level typing could identify mmRD recipients with better outcomes will not be known unless centers alter practice and type mmRD at the allele level. (Blood. 2010; 116(19):4007-4015)
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