Outcomes from Unrelated Donor Hematopoietic Stem Cell Transplantation

Perez, Lia

doi:10.1177/107327481101800402

Cited by 11 publications

(7 citation statements)

References 58 publications

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“…Therefore, transplantation using an unrelated donor is then considered with preference. Transplantation using a matched unrelated donor offers outcomes comparable with related donor HSCT due to current molecular-based HLA typing and improvements in conditioning regimens and/or supportive care [52,53]. Similar results have also been found in our study.…”

Section: Discussionsupporting

confidence: 89%

Allogeneic Peripheral Blood Stem Cell Transplantation is a Promising and Safe Choice for the Treatment of Refractory/Relapsed Acute Myelogenous Leukemia, Even with a Higher Leukemia Burden

Zhang

Yang

Song

et al. 2013

Biology of Blood and Marrow Transplantation

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The prognosis of patients with refractory/relapsed acute myelogenous leukemia (rAML) is poor. Recent studies have shown that more transplant centers are choosing allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for recipients, even with a higher leukemia burden. The purpose of the present study is to evaluate the outcome of rAML patients undergoing allo-PBSCT and to determine whether the disease status can predict the post-transplantation survival. The outcome of 58 patients (median age, 34 years; range, 14 to 52) with rAML who underwent allo-PBSCT in our institution from January 2000 until September 2011 was retrospectively studied. Thirty-three patients had complete remission (CR) before PBSCT, whereas 25 patients had no remission. Donors were matched related (31 patients) and unrelated (27 patients). Reducedintensity conditioning was used for 18 patients with rAML, and myeloablative conditioning was used for others. Sixty-six consecutive non-rAML patients (median age, 33 years; range, 15 to 51) who received an allo-PBSCT at the same period were used as a control. Full donor-type engraftment was achieved in all patients. After a median follow-up of 61 months, the 5-year overall survival of rAML patients was 54.21% AE 7.06%, which was lower than non-rAML patients (71.82% AE 6.4%, P ¼ .0386). However, the 5-year event-free survival for rAML and non-rAML patients had no statistical significance (53.54% AE 6.87% versus 62.07% AE 6.78%, P ¼ .2626). The 5-year overall survival between rAML patients who had CR and no remission before PBSCT was 56.06% AE 9.2% and 51.85% AE 10.83%, respectively (P ¼ .6408). These data demonstrate that allo-PBSCT is a promising and safe choice for the treatment of rAML, and the results were partially due to the rapid tapering of immunosuppressants in the early stage after PBSCT and prophylactic donor lymphocyte infusion. Meanwhile, the patients who did not achieve CR before PBSCT could also benefit from allo-PBSCT. Ó 2013 American Society for Blood and Marrow Transplantation. METHODS Patient Characteristics Patients were included in the rAML group if they fulfilled the following criteria: primary failure to achieve a CR after two cycles of standard induction therapy, relapse after a first CR of fewer than 6 months, second or Financial disclosure: See Acknowledgments on page 659.

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Section: Discussionsupporting

confidence: 89%

Allogeneic Peripheral Blood Stem Cell Transplantation is a Promising and Safe Choice for the Treatment of Refractory/Relapsed Acute Myelogenous Leukemia, Even with a Higher Leukemia Burden

Zhang

Yang

Song

et al. 2013

Biology of Blood and Marrow Transplantation

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“…This extensive search should precede seeking cord blood banks and HLA registries as a time-saving cost-effective alternative strategy. 37,[42][43][44]46,[58][59][60] Our considerable rate of fully-matched non-sibling family members (109 out of 523 cases) supports the rationale to routinely conduct extended family search. Future prospective multicenter studies with expanded sample size are warranted to compare other relative donors with siblings or unrelated donors.…”

Section: Discussionmentioning

confidence: 87%

Efficiency of allogeneic hematopoietic SCT from HLA fully-matched non-sibling relatives: A new prospect of exploiting extended family search

Hamidieh

Dehaghi

Paragomi

et al. 2015

Bone Marrow Transplant

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The best donors for hematopoietic SCT (HSCT) are fully-matched siblings. In patients without fully-matched siblings, HLA registries or cord blood banks are alternative strategies with some restrictions. Owing to the high rate of consanguineous marriage in our country, between 2006 and 2013, extended family searches were undertaken in Hematology-Oncology Research Center and Stem Cell Transplantation (HORCSCT), Tehran, Iran, in 523 HSCT candidates with parental consanguinity and no available HLA identical sibling. Fully-matched other-relative donors were found for 109 cases. We retrospectively studied the HSCT outcome in these patients. Median time to neutrophil engraftment was 13 days (range: 9-31days). In 83 patients, full chimerism and in 17 patients, mixed chimerism was achieved. Acute GvHD (aGvHD) grade II-IV appeared in 36 patients (33%). The frequency of aGvHD development in various familial subgroups was NS. Five patients expired before day+100. In the surviving 104 cases, chronic GvHD developed in 20 patients (19.2%). The distantly related subgroup had significantly a higher rate of cGvHD (P = 0.04). The 2-year OS and disease-free survival (DFS) were 76.7 ± 4.5% and 71.7 ± 4.7%, respectively. No significant difference in OS (P = 0.30) and DFS (P = 0.80) was unraveled between various familial relationships. Our considerable rate of fully-matched non-sibling family members and the favorable outcome support the rationale for extended family search in regions where consanguineous marriage is widely practiced.

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“…As a proportion of patients may not be able to rapidly identify a suitable MUD, other alternative graft sources, umbilical cord blood, haploidentical (haplo)related donor and mismatched unrelated donor are available [146]. The outcomes of unrelated donor transplants have improved markedly in the last years, mainly due to advances in HLA typing and supportive care [147,148].…”

Section: Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Acute Lymphoblastic Leukemia in Children

Roganović¹

2013

Leukemia

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Outcomes from Unrelated Donor Hematopoietic Stem Cell Transplantation

Cited by 11 publications

References 58 publications

Allogeneic Peripheral Blood Stem Cell Transplantation is a Promising and Safe Choice for the Treatment of Refractory/Relapsed Acute Myelogenous Leukemia, Even with a Higher Leukemia Burden

Allogeneic Peripheral Blood Stem Cell Transplantation is a Promising and Safe Choice for the Treatment of Refractory/Relapsed Acute Myelogenous Leukemia, Even with a Higher Leukemia Burden

Efficiency of allogeneic hematopoietic SCT from HLA fully-matched non-sibling relatives: A new prospect of exploiting extended family search

Acute Lymphoblastic Leukemia in Children

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