Ayuk, Francis and Beelen, Dietrich W. and Bornhaeuser, Martin and Stelljes, Matthias and Zabelina, Tatjana and Finke, Juergen and Kobbe, Guido and Wolff, Daniel and Wagner, Eva-Maria and Christopeit, Maximilian and Schmid, Christoph and Ottinger, Hellmut and Groth, Christoph and Faul, Christoph and Bertz, Hartmut and Rachlis, Elena and Wolschke, Christine and Schetelig, Johannes and Horn, Peter A. and Mytilineos, Joannis and Guellstorf, Martina and Kelsch, Reinhard and Fleischhauer, Katharina and Kroeger, Nicolaus and Bethge, Wolfgang (2018) Relative Impact of HLA Matching and Non-HLA Donor Characteristics on Outcomes of Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndrome. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 24 (12). pp. 2558-2567. ISSN 1083-8791, 1523-6536
Full text not available from this repository. (Request a copy)Abstract
Increasing donor-recipient HLA disparity is associated with negative outcomes of allogeneic hematopoietic stem cell transplantation (HSCT), but its comparative relevance amid non-HLA donor characteristics is not well established. We addressed this question in 3215 HSCTs performed between 2005 and 2013 in Germany for acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). Donors were HLA-matched related (MRD; n = 872) or unrelated (10/10 MUD, n =1553) or HLA-mismatched unrelated (<10/10 MMUD, n = 790). Overall survival (OS) was similar after MRD compared with 10/10 MUD HSCT, reflecting opposing hazards of relapse (hazard ratio [HR], 132; P < .002) and non-relapse mortality (HR, .63; P < .001). After UD HSCT, increasing HLA disparity was associated with inferior OS (HR, 1.21 [P < .02] and HR, 1.57 [P < .001] for 9/10 and <= 8/10 MMUD, respectively, compared with 10/10 MUD). Among non-HLA donor characteristics, age, sex mismatching (male recipient-female donor), and cytomegalovirus (CMV) mismatching (positive recipient-negative donor) impacted OS. Multivariate subgroup analysis showed that OS was similar after HSCT from the youngest 9/10 MMUD (<30 years) compared with the oldest 10/10 MUD (>40 years) (HR, 1.18; P= .25) and also in male patients transplanted from female 10/10 MUD compared with male 9/10 MMUD (HR, .89; P= .46). In contrast OS of CMV-positive patients tended to be better with CMV-negative 10/10 MUDs compared with CMV-positive 9/10 MMUDs (HR, 1.31; P = .04). Because of low patient numbers in subgroups, definite conclusions and establishment of a hierarchy among HLA matching and non-HLA donor characteristics could not be made. Our data suggest that the impact of donor age and sex mismatch but not CMV mismatch on outcome of allogeneic HSCT may be comparable with that of single HLA disparity. (C) 2018 American Society for Blood and Marrow Transplantation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | BONE-MARROW-TRANSPLANTATION; UNRELATED DONOR; COMPARABLE SURVIVAL; IDENTICAL SIBLINGS; GRAFT; RISK; MISMATCH; BLOOD; ALLOREACTIVITY; RECIPIENTS; HLA disparity; Non-HLA donor characteristics |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 04 Oct 2019 08:33 |
| Last Modified: | 04 Oct 2019 08:33 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13400 |
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