Comparable outcome after single-antigen-mismatched versus matched unrelated donor haematopoietic cell transplantation

Rockstroh, Alexandra; Al-Ali, Haifa Kathrin; Lange, Thoralf; Pönisch, Wolfram; Krahl, Rainer; Cross, Michael; Behre, Gerhard; Niederwieser, Dietger; Pfrepper, Christian

doi:10.1007/s00432-015-2003-5

Cited by 6 publications

(2 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although graft failure was more frequent in the MMUD group, its incidence was still relatively modest (3% versus 8%, respectively). Similar results suggesting that T cell depletion can overcome the negative impact of HLA disparity have being reported in some studies using ATG [43][44][45]. In 1 study 31 patients received RIC regimens with ATG 6 mg/kg and with a calcineurin inhibitor plus MTX or MMF as GVHD prophylaxis [44].…”

Section: Discussionsupporting

confidence: 58%

Single Antigen–Mismatched Unrelated Hematopoietic Stem Cell Transplantation Using High-Dose Post-Transplantation Cyclophosphamide Is a Suitable Alternative for Patients Lacking HLA-Matched Donors

Jorge¹,

Suárez‐Lledó²,

Pereira

et al. 2018

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

The optimal prophylaxis regimen for graft-versus-host disease (GVHD) in the setting of mismatched unrelated donor (MMUD) allogeneic hematopoietic stem cell transplantation (alloHSCT) is not defined. The use of high-dose post-transplant cyclophosphamide (PTCy) in haploidentical transplantation has proven feasible and effective in overcoming the negative impact of HLA disparity on survival. We hypothesized that PTCy could also be effective in the setting of MMUD transplantation. We retrospectively analyzed 86 consecutive adult recipients of alloHSCT in our institution, comparing 2 contemporaneous groups: PTCy MMUD (n = 26) versus matched unrelated donor (MUD) (n = 60). Graft source was primarily peripheral blood (92%). All PTCy MMUD were HLA 7/8 (differences in HLA class I loci in 92% of patients) and received PTCy plus tacrolimus ± mofetil mycophenolate as GVHD prophylaxis. No differences were observed between PTCy MMUD and MUD in the 100-day cumulative incidence of acute GVHD grades II to IV (31% versus 22%, respectively; P = .59) and III to IV (8% versus 10%, P = .67). There was a trend for a lower incidence of moderate to severe chronic GVHD at 1 year after PTCy MMUD in comparison with MUD (22% versus 41%, P = .098). No differences between PTCy MMUD and MUD were found regarding nonrelapse mortality (25% versus 18%, P = .52) or relapse rate (11% versus 19%, P = .18). Progression-free survival and overall survival at 2 years were similar in both cohorts (67% versus 54% [HR, .84; 95% CI, .38 to 1.88; P = .68] and 72% versus 57% [HR, .71; 95% CI, .31 to 1.67; P = .44], respectively). The 2-year cumulative incidence of survival free of moderate to severe chronic GVHD and relapse tended to be higher in the PTCy MMUD group (47% versus 24%; HR, .60; 95% CI, .31 to 1.14; P = .12). We conclude that HLA 7/8 MMUD transplantation using PTCy plus tacrolimus is a suitable alternative for those patients who lack a MUD.

show abstract

Section: Discussionsupporting

confidence: 58%

Single Antigen–Mismatched Unrelated Hematopoietic Stem Cell Transplantation Using High-Dose Post-Transplantation Cyclophosphamide Is a Suitable Alternative for Patients Lacking HLA-Matched Donors

Jorge¹,

Suárez‐Lledó²,

Pereira

et al. 2018

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

show abstract

“…Полученные данные о влиянии донор-ассоциированных факторов на результаты алло-ТГСК отличаются от результатов некоторых других исследований [26][27][28][29]. При анализе данных публикаций, в том числе мультицентровых исследований, мы отметили отлич-ную от нашей выборку пациентов, а также нозологическую структуру исследования и протоколы кондиционирования и профилактики РТПХ.…”

Section: R I G I N a L S T U D I E Sunclassified

Analysis of donor-associated factors in unrelated transplantations of hematopoietic stem cells in children with non-malignant diseases

Сидорова

Киргизов

Слинин

et al. 2019

Ross. ž. det. gematol. onkol.

View full text Add to dashboard Cite

The choice of the optimal donor in the absence of an HLA-compatible relative, as well as the analysis of the risks of hematopoietic stem cell transplantation (HSCT), is extremely important, especially in patients with non-cancerous diseases. The article analyzes 99 allogeneic HSCTs from unrelated donors in the bone marrow transplantation department of the Russian Children’s Clinical Hospital. The analysis included patients with acquired and congenital forms of non-malignant diseases. The choice of an optimal unrelated donor in the absence of a compatible relative donor, as well as an analysis of the risks of treatment, requires studying the factors that influence the outcome of treatment in this group of patients. It was shown that the level of 2-year overall survival (OS) was 74 % (standard deviation ± 4.7 %). At the same time, clinical manifestations of the acute graft versus host disease of grade I–IV were recorded in 67 % (n = 66) of patients, and severe forms of grade III–IV in 13 % (n = 13) of children. Chronic graft versus host disease (chGVHD) was observed in 29 % (n = 29) patients. When studying the factors associated with the donor, it was found that the differences in the HLA system have a negative effect on the incidence of chGVHD; in a (9/10) HLA-incompatible donor, it was 29 % higher (p = 0.019). Increasing the age of the donor for every 10 years consistently reduces the OS by 9–11 % (p = 0.117), however, the OS with a donor over 46 years old was 100 % (n = 7). No effect on the agents with respect to the following factors with respect to the recipient was found: by sex, blood group, serostatus for cytomegalovirus (CMV). It was noted that the combination of CMV-positive serostatus of the donor and the negative status of the recipient increases the risk of transplant rejection up to 50 % in comparison with other variants of CMV serostatus (p = 0.001). In general, the possibility of performing HSCT from an unrelated donor for patients with non-malignant diseases and possible ways of selecting the optimal donor was noted. Conflict of interest. The authors declare no conflict of interest.Funding. The study was performed without external funding.

show abstract

The Role of Low-dose Anti-thymocyte Globulin as Standard Prophylaxis in Mismatched and Matched Unrelated Hematopoietic Peripheral Stem Cell Transplantation for Hematologic Malignancies

Sakellari

Batsis

Bousiou

et al. 2017

Clinical Lymphoma Myeloma and Leukemia

View full text Add to dashboard Cite

Comparable outcome after single-antigen-mismatched versus matched unrelated donor haematopoietic cell transplantation

Abstract: Donors with one antigen mismatch are an acceptable option for patients with malignant disease for whom no fully matched donor is available.

Cited by 6 publications

References 55 publications

Single Antigen–Mismatched Unrelated Hematopoietic Stem Cell Transplantation Using High-Dose Post-Transplantation Cyclophosphamide Is a Suitable Alternative for Patients Lacking HLA-Matched Donors

Single Antigen–Mismatched Unrelated Hematopoietic Stem Cell Transplantation Using High-Dose Post-Transplantation Cyclophosphamide Is a Suitable Alternative for Patients Lacking HLA-Matched Donors

Analysis of donor-associated factors in unrelated transplantations of hematopoietic stem cells in children with non-malignant diseases

The Role of Low-dose Anti-thymocyte Globulin as Standard Prophylaxis in Mismatched and Matched Unrelated Hematopoietic Peripheral Stem Cell Transplantation for Hematologic Malignancies

Contact Info

Product

Resources

About