Is there a graft-versus-leukaemia effect in the absence of graft-versus-host disease in patients undergoing bone marrow transplantation for acute leukaemia?

O. Ringdén, M. Labopin, N. C. Gorin, N. Schmitz, U. W. Schaefer, H. G. Prentice, L. Bergmann, J. P. Jouet, F. Mandelli, D. Blaise, L. Fouillard, F. Frassoni

Research output: Contribution to journalArticle

Abstract

During a 13-year period, 5200 autografts, 1039 HLA-identical sibling transplants without acute or chronic graft-vs.-host disease (GVHD) and 67 twins were reported to the European Group for Blood and Marrow Transplantation EBMT. Follow-up time was a median of 32 months. Diagnoses were acute myeloid leukaemia (AML, 4521) and acute lymphoblastic leukaemia (ALL, 1785) in first complete remission. The probability of relapse at 5 years was 51 ± 1% in the autografts, 45 ± 8% in the twins and 34 ± 2% among the HLA-identical siblings (auto vs. sibs, P <0.0001). In multivariate analyses, the following factors were significantly associated with an increased risk of relapse: ALL vs. AML M3 [relapse rate (RR) 2.29, P <0.0001], AML non-M3 vs. AML M3 (RR 1.8, P <0.0001), autograft vs. sibling transplant (RR 1.76, P <0.0001), interval diagnosis to transplantation <261 d (RR 1.45, P <0.001) and other conditioning vs. total body irradiation (RR 1.16, P = 0.001). Transplant-related mortality was the same in the three groups at approximately 10% at 2 years. Five-year leukaemia-free survival was 42 ± 1% in the autografts, 44 ± 8% in the twins and 58 ± 2% among the siblings (auto vs. sibs, P <0.0001). The factors significant for relapse were also significant in multivariate analyses for leukaemia-free survival. In addition, children had a significantly better leukaemia-free survival than adults (RR 0.82, P <0.0001). Recipients of bone marrow from HLA-identical siblings without GVHD had a lower risk of relapse and a better leukaemia-free survival than recipients of autografts. This may be as a result of a graft-vs.-leukaemia effect in the absence of GVHD.

Original languageEnglish
Pages (from-to)1130-1137
Number of pages8
JournalBritish Journal of Haematology
Volume111
Issue number4
DOIs
Publication statusPublished - 2000

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Keywords

  • Acute leukaemia
  • Allogeneic
  • Autologous and syngeneic bone marrow transplantation
  • Graft-versus-host disease
  • Graft-vesus-leukaemia

ASJC Scopus subject areas

  • Hematology

Cite this

Ringdén, O., Labopin, M., Gorin, N. C., Schmitz, N., Schaefer, U. W., Prentice, H. G., Bergmann, L., Jouet, J. P., Mandelli, F., Blaise, D., Fouillard, L., & Frassoni, F. (2000). Is there a graft-versus-leukaemia effect in the absence of graft-versus-host disease in patients undergoing bone marrow transplantation for acute leukaemia? British Journal of Haematology, 111(4), 1130-1137. https://doi.org/10.1046/j.1365-2141.2000.02493.x