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Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study
A. Ruggeri, G. Battipaglia, M. Labopin, G. Ehninger, D. Beelen, J. Tischer, A. Ganser, R. Schwerdtfeger, B. Glass, J. Finke, M. Michallet, M. Stelljes, P. Jindra, R. Arnold, N. Kröger, M. Mohty, A. Nagler,
Jazyk angličtina Země Velká Británie
Typ dokumentu srovnávací studie, časopisecké články, práce podpořená grantem
Grantová podpora
NV15-25809A
MZ0
CEP - Centrální evidence projektů
NV15-30661A
MZ0
CEP - Centrální evidence projektů
Digitální knihovna NLK
Plný text - Článek
Plný text - Článek
Zdroj
Zdroj
NLK
BioMedCentral
od 2008-12-01
BioMedCentral Open Access
od 2008
Directory of Open Access Journals
od 2008
Free Medical Journals
od 2008
PubMed Central
od 2008
Europe PubMed Central
od 2008
ProQuest Central
od 2009-01-01
Open Access Digital Library
od 2008-01-01
Open Access Digital Library
od 2008-01-01
Medline Complete (EBSCOhost)
od 2009-01-17
Health & Medicine (ProQuest)
od 2009-01-01
ROAD: Directory of Open Access Scholarly Resources
od 2008
Springer Nature OA/Free Journals
od 2008-12-01
- MeSH
- akutní myeloidní leukemie komplikace mortalita terapie MeSH
- dárci krve * MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoc štěpu proti hostiteli MeSH
- nepříbuzný dárce MeSH
- přežití bez známek nemoci MeSH
- přežívání štěpu MeSH
- recidiva MeSH
- registrace MeSH
- retrospektivní studie MeSH
- senioři MeSH
- sourozenci MeSH
- transplantace hematopoetických kmenových buněk škodlivé účinky metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: Allogeneic stem cell transplantation is the only curative option for patients with acute myeloid leukemia (AML) experiencing relapse. Either matched sibling donor (MSD) or unrelated donor (UD) is indicated. METHODS: We analyzed 1554 adults with AML transplanted from MSD (n = 961) or UD (n = 593, HLA-matched 10/10, n = 481; 9/10, n = 112). Compared to MSD, UD recipients were older (49 vs 52 years, p = 0.001), transplanted more recently (2009 vs 2006, p = 0.001), and with a longer interval to transplant (10 vs 9 months, p = 0.001). Conditioning regimen was more frequently myeloablative for patients transplanted with a MSD (61 vs 46 %, p = 0.001). Median follow-up was 28 (range 3-157) months. RESULTS: Cumulative incidence (CI) of neutrophil engraftment (p = 0.07), grades II-IV acute GVHD (p = 0.11), chronic GVHD (p = 0.9), and non-relapse mortality (NRM, p = 0.24) was not different according to the type of donor. At 2 years, CI of relapse (relapse incidence (RI)) was 57 vs 49 % (p = 0.001). Leukemia-free survival (LFS) at 2 years was 21 vs 26 % (p = 0.001), and overall survival (OS) was 26 vs 33 % (p = 0.004) for MSD vs UD, respectively. Chronic GVHD as time-dependent variable was associated with lower RI (HR 0.78, p = 0.05), higher NRM (HR 1.71, p = 0.001), and higher OS (HR 0.69, p = 0.001). According to HLA match, RI was 57 vs 50 vs 45 %, (p = 0.001) NRM was 23 vs 23 vs 29 % (p = 0.26), and LFS at 2 years was 21 vs 27 vs 25 % (p = 0.003) for MSD, 10/10, and 9/10 UD, respectively. In multivariate analysis adjusted for differences between the two groups, UD was associated with lower RI (HR 0.76, p = 0.001) and higher LFS (HR 0.83, p = 0.001) compared to MSD. Interval between diagnosis and transplant was the other factor associated with better outcomes (RI (HR 0.62, p < 0.001) and LFS (HR 0.67, p < 0.001)). CONCLUSIONS: Transplantation using UD was associated with better LFS and lower RI compared to MSD for high-risk patients with AML transplanted in first relapse.
Charité Universitatsmedizin 10117 Berlin Germany
Department of Bone Marrow Transplantation University Hospital Essen Essen Germany
Department of Hematology Lyon Sud Hospital Hospices Civils de Lyon Pierre Bénite France
Department of Internal Medicine 3 UH of Munich Munich Germany
Department of Medicine A University of Muenster Munster Germany
Departments of Hematology Oncology Charles University Hospital Pilsen Czech Republic
Citace poskytuje Crossref.org
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- $a Ruggeri, Annalisa $u Service d'Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, 184 Rue du Faubourg Saint Antoine, 75012, Paris, France. annalisaruggeri80@hotmail.com.
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- $a Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study / $c A. Ruggeri, G. Battipaglia, M. Labopin, G. Ehninger, D. Beelen, J. Tischer, A. Ganser, R. Schwerdtfeger, B. Glass, J. Finke, M. Michallet, M. Stelljes, P. Jindra, R. Arnold, N. Kröger, M. Mohty, A. Nagler,
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- $a BACKGROUND: Allogeneic stem cell transplantation is the only curative option for patients with acute myeloid leukemia (AML) experiencing relapse. Either matched sibling donor (MSD) or unrelated donor (UD) is indicated. METHODS: We analyzed 1554 adults with AML transplanted from MSD (n = 961) or UD (n = 593, HLA-matched 10/10, n = 481; 9/10, n = 112). Compared to MSD, UD recipients were older (49 vs 52 years, p = 0.001), transplanted more recently (2009 vs 2006, p = 0.001), and with a longer interval to transplant (10 vs 9 months, p = 0.001). Conditioning regimen was more frequently myeloablative for patients transplanted with a MSD (61 vs 46 %, p = 0.001). Median follow-up was 28 (range 3-157) months. RESULTS: Cumulative incidence (CI) of neutrophil engraftment (p = 0.07), grades II-IV acute GVHD (p = 0.11), chronic GVHD (p = 0.9), and non-relapse mortality (NRM, p = 0.24) was not different according to the type of donor. At 2 years, CI of relapse (relapse incidence (RI)) was 57 vs 49 % (p = 0.001). Leukemia-free survival (LFS) at 2 years was 21 vs 26 % (p = 0.001), and overall survival (OS) was 26 vs 33 % (p = 0.004) for MSD vs UD, respectively. Chronic GVHD as time-dependent variable was associated with lower RI (HR 0.78, p = 0.05), higher NRM (HR 1.71, p = 0.001), and higher OS (HR 0.69, p = 0.001). According to HLA match, RI was 57 vs 50 vs 45 %, (p = 0.001) NRM was 23 vs 23 vs 29 % (p = 0.26), and LFS at 2 years was 21 vs 27 vs 25 % (p = 0.003) for MSD, 10/10, and 9/10 UD, respectively. In multivariate analysis adjusted for differences between the two groups, UD was associated with lower RI (HR 0.76, p = 0.001) and higher LFS (HR 0.83, p = 0.001) compared to MSD. Interval between diagnosis and transplant was the other factor associated with better outcomes (RI (HR 0.62, p < 0.001) and LFS (HR 0.67, p < 0.001)). CONCLUSIONS: Transplantation using UD was associated with better LFS and lower RI compared to MSD for high-risk patients with AML transplanted in first relapse.
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