Abstract
Allogeneic stem cell transplantation (alloSCT) for patients with refractory anaemia may result in a 50% event-free survival, but the high non-relapse mortality (NRM) precludes a general application of this therapeutic modality. This study evaluated the impact of various pre-transplant variables, including disease duration, intensity of the conditioning regimen, type of donor and year of transplantation on outcome. The study population consisted of 374 patients; 244 were transplanted from human leucocyte antigen (HLA)-identical siblings and 130 patients from matched unrelated donors. The median age was 39 years. One hundred and two patients were transplanted after reduced intensity conditioning (RIC). The overall 4-year survival was 52%. The 4-year survival of patients transplanted with HLAidentical sibling donors and matched unrelated donors was 52% and 50%, respectively. Multivariate analysis showed an improved survival (P = 0.05) and a lower NRM (P = 0.02) when the transplantation was performed in recent years. Increasing age, and disease duration of >12 months were associated with inferior survival. RIC resulted in a similar survival despite an increased relapse risk (P = 0.02). This improved outcome permits alloSCT in patients older than 50 years of age, even with the use of matched unrelated donors. AlloSCT should be preferentially performed early after diagnosis after careful analysis of prognostic variables.
| Original language | English |
|---|---|
| Pages (from-to) | 627-636 |
| Number of pages | 10 |
| Journal | British Journal of Haematology |
| Volume | 146 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2009 |
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Keywords
- Allogeneic stem cell transplantation
- Hla-Identical sibling donor
- Matched unrelated donor.
- Reduced intensity conditioning regimens
- Refractory anaemia
ASJC Scopus subject areas
- Hematology
Cite this
Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors : Delay of the transplant is associated with inferior survival. / Witte, Theo de; Brand, Ronald; Biezen, Anja van; Mufti, Ghulam; Ruutu, Tapani; Finke, Jürgen; Borne, Peter von dem; Vitek, Antonin; Delforge, Michel; Alessandrino, Paolo; Harlahakis, Nicolas; Russell, Nigel; Martino, Roberto; Verdonck, Leo; Kröger, Nicholas; Niederwieser, Dietger.
In: British Journal of Haematology, Vol. 146, No. 6, 2009, p. 627-636.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors
T2 - Delay of the transplant is associated with inferior survival
AU - Witte, Theo de
AU - Brand, Ronald
AU - Biezen, Anja van
AU - Mufti, Ghulam
AU - Ruutu, Tapani
AU - Finke, Jürgen
AU - Borne, Peter von dem
AU - Vitek, Antonin
AU - Delforge, Michel
AU - Alessandrino, Paolo
AU - Harlahakis, Nicolas
AU - Russell, Nigel
AU - Martino, Roberto
AU - Verdonck, Leo
AU - Kröger, Nicholas
AU - Niederwieser, Dietger
PY - 2009
Y1 - 2009
N2 - Allogeneic stem cell transplantation (alloSCT) for patients with refractory anaemia may result in a 50% event-free survival, but the high non-relapse mortality (NRM) precludes a general application of this therapeutic modality. This study evaluated the impact of various pre-transplant variables, including disease duration, intensity of the conditioning regimen, type of donor and year of transplantation on outcome. The study population consisted of 374 patients; 244 were transplanted from human leucocyte antigen (HLA)-identical siblings and 130 patients from matched unrelated donors. The median age was 39 years. One hundred and two patients were transplanted after reduced intensity conditioning (RIC). The overall 4-year survival was 52%. The 4-year survival of patients transplanted with HLAidentical sibling donors and matched unrelated donors was 52% and 50%, respectively. Multivariate analysis showed an improved survival (P = 0.05) and a lower NRM (P = 0.02) when the transplantation was performed in recent years. Increasing age, and disease duration of >12 months were associated with inferior survival. RIC resulted in a similar survival despite an increased relapse risk (P = 0.02). This improved outcome permits alloSCT in patients older than 50 years of age, even with the use of matched unrelated donors. AlloSCT should be preferentially performed early after diagnosis after careful analysis of prognostic variables.
AB - Allogeneic stem cell transplantation (alloSCT) for patients with refractory anaemia may result in a 50% event-free survival, but the high non-relapse mortality (NRM) precludes a general application of this therapeutic modality. This study evaluated the impact of various pre-transplant variables, including disease duration, intensity of the conditioning regimen, type of donor and year of transplantation on outcome. The study population consisted of 374 patients; 244 were transplanted from human leucocyte antigen (HLA)-identical siblings and 130 patients from matched unrelated donors. The median age was 39 years. One hundred and two patients were transplanted after reduced intensity conditioning (RIC). The overall 4-year survival was 52%. The 4-year survival of patients transplanted with HLAidentical sibling donors and matched unrelated donors was 52% and 50%, respectively. Multivariate analysis showed an improved survival (P = 0.05) and a lower NRM (P = 0.02) when the transplantation was performed in recent years. Increasing age, and disease duration of >12 months were associated with inferior survival. RIC resulted in a similar survival despite an increased relapse risk (P = 0.02). This improved outcome permits alloSCT in patients older than 50 years of age, even with the use of matched unrelated donors. AlloSCT should be preferentially performed early after diagnosis after careful analysis of prognostic variables.
KW - Allogeneic stem cell transplantation
KW - Hla-Identical sibling donor
KW - Matched unrelated donor.
KW - Reduced intensity conditioning regimens
KW - Refractory anaemia
UR - http://www.scopus.com/inward/record.url?scp=77449147495&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77449147495&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2141.2009.07809.x
DO - 10.1111/j.1365-2141.2009.07809.x
M3 - Article
VL - 146
SP - 627
EP - 636
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 6
ER -