Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: Delay of the transplant is associated with inferior survival

Theo de Witte, Ronald Brand, Anja van Biezen, Ghulam Mufti, Tapani Ruutu, Jürgen Finke, Peter von dem Borne, Antonin Vitek, Michel Delforge, Paolo Alessandrino, Nicolas Harlahakis, Nigel Russell, Roberto Martino, Leo Verdonck, Nicholas Kröger, Dietger Niederwieser

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)627-636
Number of pages10
JournalBritish Journal of Haematology
Volume146
Issue number6
DOIs
Publication statusPublished - 2009

Keywords

  • Allogeneic stem cell transplantation
  • Hla-Identical sibling donor
  • Matched unrelated donor.
  • Reduced intensity conditioning regimens
  • Refractory anaemia

ASJC Scopus subject areas

  • Hematology

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    Witte, T. D., Brand, R., Biezen, A. V., Mufti, G., Ruutu, T., Finke, J., Borne, P. V. D., Vitek, A., Delforge, M., Alessandrino, P., Harlahakis, N., Russell, N., Martino, R., Verdonck, L., Kröger, N., & Niederwieser, D. (2009). Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: Delay of the transplant is associated with inferior survival. British Journal of Haematology, 146(6), 627-636. https://doi.org/10.1111/j.1365-2141.2009.07809.x