Donor search or autografting in patients with acute leukaemia who lack an HLA-identical sibling? A matched-pair analysis. Acute Leukaemia Working Party of the European Cooperative Group for Blood and Marrow Transplantation (EBMT) and the International Marrow Unrelated Search and Transplant (IMUST) Study

Bone Marrow Transplantation
Olle RingdenN C Gorin

Abstract

One hundred and ninety-one patients with acute leukaemia who received bone marrow from HLA-A, -B and -DR identical unrelated donors and were reported to EBMT and/or IMUST, were matched with 382 patients receiving autologous bone marrow for diagnosis, age, stage of disease and year of transplantation. Transplant-related mortality (TRM) was significantly higher in recipients of unrelated marrow compared to autograft recipients, 44 +/- 4% (+/- 95% confidence interval) and 15 +/- 3% at 2 years in the two groups, respectively (P < 10(-4)). In contrast, relapse probability was lower in recipients of unrelated marrow, being 32 +/- 5% at 2 years compared to 55 +/- 3% in recipients of autografts (P < 10(-4)). Two-year leukaemia-free survival (LFS) in patients with acute lymphoblastic leukaemia was 39 +/- 5% and 32 +/- 3% in the two groups, respectively. Among patients with acute myeloid leukaemia (AML), the corresponding figures were 36 +/- 6% and 46 +/- 5% in the two groups, respectively (P = NS). In AML in first remission (CR-1), the 2-year survival was 42 +/- 10% in recipients of unrelated bone marrow, compared to 69 +/- 8% in autograft recipients (P = 0.008). When all patients with acute leukaemia were included, the 2-year LFS was 3...Continue Reading

Citations

Dec 21, 2000·Current Oncology Reports·E Abella, Y Ravindranath
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May 1, 2002·Transplantation·Maria Pia PistilloGiovanni Battista Ferrara
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Jul 8, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Michael B TomblynDaniel J Weisdorf
May 9, 2001·Leukemia & Lymphoma·J SierraC Anasetti
Feb 13, 2003·Pediatric Clinics of North America·Ulrike Reiss, Ellen Bolotin
Mar 21, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Petros ChristopoulosJürgen Finke
Nov 9, 2005·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Theresa HahnPhilip L McCarthy
Jun 10, 2008·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Rukset Attar, Erkut Attar
Aug 5, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Olle RingdénVanderson Rocha
May 23, 2001·Leukemia·F R Appelbaum
Sep 13, 2002·Oncogene·Marie KnockaertLaurent Meijer
Apr 20, 2002·Blood·Nancy BuninUNKNOWN National Marrow Donor Program Working Group

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