Centre characteristics and procedure-related factors have an impact on outcomes of allogeneic transplantation for patients with CLL: a retrospective analysis from the European Society for Blood and Marrow Transplantation (EBMT)
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie
PubMed
28589551
DOI
10.1111/bjh.14791
Knihovny.cz E-zdroje
- Klíčová slova
- allogeneic stem cell transplantation, centre effects, chronic lymphocytic leukaemia, frailties, risk factor analysis,
- MeSH
- chronická lymfatická leukemie mortalita terapie MeSH
- dospělí MeSH
- Kaplanův-Meierův odhad MeSH
- Karnofského skóre MeSH
- lidé středního věku MeSH
- lidé MeSH
- odborná praxe statistika a číselné údaje MeSH
- poskytování zdravotní péče statistika a číselné údaje MeSH
- příprava pacienta k transplantaci metody MeSH
- recidiva MeSH
- registrace MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- transplantace hematopoetických kmenových buněk metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
The best approach for allogeneic haematopoietic stem cell transplantations (alloHCT) in patients with chronic lymphocytic leukaemia (CLL) is unknown. We therefore analysed the impact of procedure- and centre-related factors on 5-year event-free survival (EFS) in a large retrospective study. Data of 684 CLL patients who received a first alloHCT between 2000 and 2011 were analysed by multivariable Cox proportional hazards models with a frailty component to investigate unexplained centre heterogeneity. Five-year EFS of the whole cohort was 37% (95% confidence interval [CI], 34-42%). Larger numbers of CLL alloHCTs (hazard ratio [HR] 0·96, P = 0·002), certification of quality management (HR 0·7, P = 0·045) and a higher gross national income per capita (HR 0·4, P = 0·04) improved EFS. In vivo T-cell depletion (TCD) with alemtuzumab compared to no TCD (HR 1·5, P = 0·03), and a female donor compared to a male donor for a male patient (HR 1·4, P = 0·02) had a negative impact on EFS, but not non-myeloablative versus more intensive conditioning. After correcting for patient-, procedure- and centre-characteristics, significant variation in centre outcomes persisted. In conclusion, further research on the impact of centre and procedural characteristics is warranted. Non-myeloablative conditioning appears to be the preferable approach for patients with CLL.
BMT Unit Department of Haematology Rigshospitalet Copenhagen Denmark
Bone Marrow Transplantation Centre University Hospital Eppendorf Hamburg Germany
Centre Hospitalier Lyon Sud Hématologie Lyon France
Department for Haematology University Hospital Basel Switzerland
Department of Biology University of Tor Vergata Rome Italy
Department of Bone Marrow Transplantation University Hospital Essen Germany
Department of Haematology Institute of Haematology and Blood Transfusion Prague Czech Republic
Department of Haematology Oncology Charles University Hospital Pilsen Czech Republic
Department of Medicine Haematology Oncology University of Freiburg Freiburg Germany
DKMS Clinical Trials Unit Dresden Germany
Hematologia Hospital de la Santa Creu i Sant Pau Barcelona Spain
Institute of Haematology and Oncology Department of Haematology Hospital Clinic Barcelona Spain
Medical Department 1 University Hospital of the Technical University Dresden Dresden Germany
Medizinische Klinik u Poliklinik 5 University of Heidelberg Heidelberg Germany
Radboud University Medical Centre Nijmegen the Netherlands
University Medical Centre Maastricht Maastricht The Netherlands
Citace poskytuje Crossref.org
