Long-term outcomes of HLA-matched sibling compared with mismatched related and unrelated donor hematopoietic stem cell transplantation for chronic phase chronic myelogenous leukemia: a single institution experience in China
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Qi-fa Liu & Xiao-jun Xu & Yin-kui Chen & Jing Sun & Yu Zhang & Zhi-ping Fan & Dan Xu & Qian-li Jiang & Yong-qiang Wei & Fen Huang & Ru Feng & Xiao-li
- چاپ و سال / کشور: 2010
Description
Allogeneic hematopoetic stem cell transplantation (allo-HSCT) remains the only curative therapy for chronic myelogenous leukemia (CML). In this study, the long-term outcomes of HLA-matched sibling donor (MSD) with mismatched related donor (MRD) and unrelated donor (URD) transplantation for CML in the first chronic phase (CML-CP1) using different graft vs. host disease (GVHD) prophylaxis regimens according to donor source and the degree of HLA matching were compared. The data of 91 patients with CML-CP1 were analyzed with respect to GVHD, overall survival (OS), and transplant-related mortality (TRM). The incidence of grade II–IV acute GVHD was 25.5% in the MSD and 40.5% in the MRD/URD group (P= 0.133). The 1-year cumulative incidence of chronic GVHD was not different between the MSD and the MRD/URD groups, while extensive chronic GVHD was different between the two groups (31.9% vs. 10.8%, P=0.023). The 5-year cumulative relapse rate was not different between the MSD and the MRD/URD groups, while TRM was different between the two groups (6.6% vs. 26.3%, P=0.010). The 5- year cumulative OS was 90.9%, 71.5%, and 85.4% in the MSD, the MRD/URD, and the HLA allele-matched URD transplantation, respectively (MSD vs. MRD/URD, P= 0.013; MSD vs. HLA allele-matched URD, P=0.437). In conclusion, survival in HLA allele-matched URD is equivalent to MSD, but in MRD and mismatched URD is inferior to MSD in patients with CML-CP1 undergoing allo-HSCT using different GVHD prophylaxis regimens according to donor source and degree of HLA matching. Patients undergoing MRD/URD transplantation have an equal quality of life as patients undergoing MSD transplantation.
Ann Hematol (2011) 90:331–341 DOI 10.1007/s00277-010-1081-3 Received: 23 February 2010 / Accepted: 8 September 2010 / Published online: 25 September 2010
