The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation

Olle Ringdén; Steven Z Pavletic; Claudio Anasetti; A John Barrett; Tao Wang; Dan Wang; Joseph H Antin; Paolo Di Bartolomeo; Brian J Bolwell; Christopher Bredeson; Mitchell S Cairo; Robert P Gale; Vikas Gupta; Theresa Hahn; Gregory A Hale; Jorg Halter; Madan Jagasia; Mark R Litzow; Franco Locatelli; David I Marks; Philip L McCarthy; Morton J Cowan; Effie W Petersdorf; James A Russell; Gary J Schiller; Harry Schouten; Stephen Spellman; Leo F Verdonck; John R Wingard; Mary M Horowitz; Mukta Arora

doi:10.1182/blood-2008-07-163212

The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation

Olle Ringdén^*
, Steven Z Pavletic
, Claudio Anasetti
, A John Barrett
, Tao Wang
, Dan Wang
, Joseph H Antin
, Paolo Di Bartolomeo
, Brian J Bolwell
, Christopher Bredeson
, Mitchell S Cairo
, Robert P Gale
, Vikas Gupta
, Theresa Hahn
, Gregory A Hale
, Jorg Halter
, Madan Jagasia
, Mark R Litzow
, Franco Locatelli
, David I Marks

Philip L McCarthy, Morton J Cowan, Effie W Petersdorf, James A Russell, Gary J Schiller, Harry Schouten, Stephen Spellman, Leo F Verdonck, John R Wingard, Mary M Horowitz, Mukta Arora

^*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivista › Articolo

Abstract

Do some patients benefit from an unrelated donor (URD) transplant because of a stronger graft-versus-leukemia (GVL) effect? We analyzed 4099 patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic myeloid leukemia (CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation (HCT) from an URD (8/8 human leukocyte antigen [HLA]matched, n = 941) or HLA-identical sibling donor (n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality (TRM; relative risk [RR], 2.76; P < .001) and relapse (RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival (LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant (RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same (ALL, CML) or worse (AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect. (Blood. 2009; 113: 3110-3118)

Lingua originale	Inglese
pagine (da-a)	3110-3118
Numero di pagine	11
Rivista	Blood
Volume	113
Numero di pubblicazione	13
DOI	https://doi.org/10.1182/blood-2008-07-163212
Stato di pubblicazione	Pubblicato - 2009

All Science Journal Classification (ASJC) codes

Biochimica
Immunologia
Ematologia
Biologia Cellulare

Keywords

N/A

OSS delle Nazioni Unite

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10.1182/blood-2008-07-163212

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Ringdén, O., Pavletic, S. Z., Anasetti, C., Barrett, A. J., Wang, T., Wang, D., Antin, J. H., Di Bartolomeo, P., Bolwell, B. J., Bredeson, C., Cairo, M. S., Gale, R. P., Gupta, V., Hahn, T., Hale, G. A., Halter, J., Jagasia, M., Litzow, M. R., Locatelli, F., ... Arora, M. (2009). The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation. Blood, 113(13), 3110-3118. https://doi.org/10.1182/blood-2008-07-163212

@article{e94fd488ea3e40f3a7b27d72b3f62d8c,

title = "The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation",

abstract = "Do some patients benefit from an unrelated donor (URD) transplant because of a stronger graft-versus-leukemia (GVL) effect? We analyzed 4099 patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic myeloid leukemia (CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation (HCT) from an URD (8/8 human leukocyte antigen [HLA]matched, n = 941) or HLA-identical sibling donor (n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality (TRM; relative risk [RR], 2.76; P < .001) and relapse (RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival (LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant (RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same (ALL, CML) or worse (AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect. (Blood. 2009; 113: 3110-3118)",

keywords = "N/A, N/A",

author = "Olle Ringd{\'e}n and Pavletic, \{Steven Z\} and Claudio Anasetti and Barrett, \{A John\} and Tao Wang and Dan Wang and Antin, \{Joseph H\} and \{Di Bartolomeo\}, Paolo and Bolwell, \{Brian J\} and Christopher Bredeson and Cairo, \{Mitchell S\} and Gale, \{Robert P\} and Vikas Gupta and Theresa Hahn and Hale, \{Gregory A\} and Jorg Halter and Madan Jagasia and Litzow, \{Mark R\} and Franco Locatelli and Marks, \{David I\} and McCarthy, \{Philip L\} and Cowan, \{Morton J\} and Petersdorf, \{Effie W\} and Russell, \{James A\} and Schiller, \{Gary J\} and Harry Schouten and Stephen Spellman and Verdonck, \{Leo F\} and Wingard, \{John R\} and Horowitz, \{Mary M\} and Mukta Arora",

year = "2009",

doi = "10.1182/blood-2008-07-163212",

language = "English",

volume = "113",

pages = "3110--3118",

journal = "Blood",

issn = "1528-0020",

publisher = "Elsevier B.V.",

number = "13",

}

Ringdén, O, Pavletic, SZ, Anasetti, C, Barrett, AJ, Wang, T, Wang, D, Antin, JH, Di Bartolomeo, P, Bolwell, BJ, Bredeson, C, Cairo, MS, Gale, RP, Gupta, V, Hahn, T, Hale, GA, Halter, J, Jagasia, M, Litzow, MR, Locatelli, F, Marks, DI, McCarthy, PL, Cowan, MJ, Petersdorf, EW, Russell, JA, Schiller, GJ, Schouten, H, Spellman, S, Verdonck, LF, Wingard, JR, Horowitz, MM & Arora, M 2009, 'The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation', Blood, vol. 113, n. 13, pagg. 3110-3118. https://doi.org/10.1182/blood-2008-07-163212

TY - JOUR

T1 - The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation

AU - Ringdén, Olle

AU - Pavletic, Steven Z

AU - Anasetti, Claudio

AU - Barrett, A John

AU - Wang, Tao

AU - Wang, Dan

AU - Antin, Joseph H

AU - Di Bartolomeo, Paolo

AU - Bolwell, Brian J

AU - Bredeson, Christopher

AU - Cairo, Mitchell S

AU - Gale, Robert P

AU - Gupta, Vikas

AU - Hahn, Theresa

AU - Hale, Gregory A

AU - Halter, Jorg

AU - Jagasia, Madan

AU - Litzow, Mark R

AU - Locatelli, Franco

AU - Marks, David I

AU - McCarthy, Philip L

AU - Cowan, Morton J

AU - Petersdorf, Effie W

AU - Russell, James A

AU - Schiller, Gary J

AU - Schouten, Harry

AU - Spellman, Stephen

AU - Verdonck, Leo F

AU - Wingard, John R

AU - Horowitz, Mary M

AU - Arora, Mukta

PY - 2009

Y1 - 2009

N2 - Do some patients benefit from an unrelated donor (URD) transplant because of a stronger graft-versus-leukemia (GVL) effect? We analyzed 4099 patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic myeloid leukemia (CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation (HCT) from an URD (8/8 human leukocyte antigen [HLA]matched, n = 941) or HLA-identical sibling donor (n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality (TRM; relative risk [RR], 2.76; P < .001) and relapse (RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival (LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant (RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same (ALL, CML) or worse (AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect. (Blood. 2009; 113: 3110-3118)

AB - Do some patients benefit from an unrelated donor (URD) transplant because of a stronger graft-versus-leukemia (GVL) effect? We analyzed 4099 patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic myeloid leukemia (CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation (HCT) from an URD (8/8 human leukocyte antigen [HLA]matched, n = 941) or HLA-identical sibling donor (n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality (TRM; relative risk [RR], 2.76; P < .001) and relapse (RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival (LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant (RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same (ALL, CML) or worse (AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect. (Blood. 2009; 113: 3110-3118)

KW - N/A

UR - https://publicatt.unicatt.it/handle/10807/258222

UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=63849276967&origin=inward

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=63849276967&origin=inward

U2 - 10.1182/blood-2008-07-163212

DO - 10.1182/blood-2008-07-163212

M3 - Article

SN - 1528-0020

VL - 113

SP - 3110

EP - 3118

JO - Blood

JF - Blood

IS - 13

ER -

The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation

Abstract

All Science Journal Classification (ASJC) codes

Keywords

OSS delle Nazioni Unite

Accesso al documento

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