Stem cell transplantation from identical twins in patients with myelodysplastic syndromes

N. Kröger, R. Brand, A. van Biezen, D. Bron, D. Blaise, E. Hellström-Lindberg, G. Gahrton, R. Powles, T. Littlewood, B. Chapuis, A. Zander, V. Koza, D. Niederwieser, T. de Witte, A. Gratwohl, R. Barge, D. Bunjes, A. Devergie, J. L. Harousseau, B. SimonssonJ. Reiffers, E. P. Alessandrino, B. Hertenstein, H. J. Kolb, M. Attal, A. Vitek, M. A. Sanz, J. Holowiecki, J. M. Moraleda, A. C. Newland, J. Finke

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-dentical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P = 0.02) and 16 vs 26 days (P = 0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27%; P = 0.05). The 5 year cumulative incidence of relapse was 32% (95% CI: 29-35%) for the siblings and 39% (95% CI: 26-60%; P = 0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34% (95% CI: 14-54%) Ps 28% (95% CI: 25-31 %; P = 0.2) and 36% (95% CI: 15-57%) vs 32% (95% CI: 29-35%; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95% CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95% CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95% CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.

Original languageEnglish
Pages (from-to)37-43
Number of pages7
JournalBone Marrow Transplantation
Volume35
Issue number1
DOIs
Publication statusPublished - Jan 2005

Fingerprint

Monozygotic Twins
Myelodysplastic Syndromes
Stem Cell Transplantation
Siblings
Recurrence
Mortality
Transplantation
Survival
Incidence
Disease-Free Survival
Leukocytes
Stem Cells
Therapeutics
Blood Platelets
Multivariate Analysis
Databases

Keywords

  • Allogeneic stem cell transplantation
  • Myelodysplastic syndrome
  • Syngeneic stem cell transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Kröger, N., Brand, R., van Biezen, A., Bron, D., Blaise, D., Hellström-Lindberg, E., ... Finke, J. (2005). Stem cell transplantation from identical twins in patients with myelodysplastic syndromes. Bone Marrow Transplantation, 35(1), 37-43. https://doi.org/10.1038/sj.bmt.1704701

Stem cell transplantation from identical twins in patients with myelodysplastic syndromes. / Kröger, N.; Brand, R.; van Biezen, A.; Bron, D.; Blaise, D.; Hellström-Lindberg, E.; Gahrton, G.; Powles, R.; Littlewood, T.; Chapuis, B.; Zander, A.; Koza, V.; Niederwieser, D.; de Witte, T.; Gratwohl, A.; Barge, R.; Bunjes, D.; Devergie, A.; Harousseau, J. L.; Simonsson, B.; Reiffers, J.; Alessandrino, E. P.; Hertenstein, B.; Kolb, H. J.; Attal, M.; Vitek, A.; Sanz, M. A.; Holowiecki, J.; Moraleda, J. M.; Newland, A. C.; Finke, J.

In: Bone Marrow Transplantation, Vol. 35, No. 1, 01.2005, p. 37-43.

Research output: Contribution to journalArticle

Kröger, N, Brand, R, van Biezen, A, Bron, D, Blaise, D, Hellström-Lindberg, E, Gahrton, G, Powles, R, Littlewood, T, Chapuis, B, Zander, A, Koza, V, Niederwieser, D, de Witte, T, Gratwohl, A, Barge, R, Bunjes, D, Devergie, A, Harousseau, JL, Simonsson, B, Reiffers, J, Alessandrino, EP, Hertenstein, B, Kolb, HJ, Attal, M, Vitek, A, Sanz, MA, Holowiecki, J, Moraleda, JM, Newland, AC & Finke, J 2005, 'Stem cell transplantation from identical twins in patients with myelodysplastic syndromes', Bone Marrow Transplantation, vol. 35, no. 1, pp. 37-43. https://doi.org/10.1038/sj.bmt.1704701
Kröger N, Brand R, van Biezen A, Bron D, Blaise D, Hellström-Lindberg E et al. Stem cell transplantation from identical twins in patients with myelodysplastic syndromes. Bone Marrow Transplantation. 2005 Jan;35(1):37-43. https://doi.org/10.1038/sj.bmt.1704701
Kröger, N. ; Brand, R. ; van Biezen, A. ; Bron, D. ; Blaise, D. ; Hellström-Lindberg, E. ; Gahrton, G. ; Powles, R. ; Littlewood, T. ; Chapuis, B. ; Zander, A. ; Koza, V. ; Niederwieser, D. ; de Witte, T. ; Gratwohl, A. ; Barge, R. ; Bunjes, D. ; Devergie, A. ; Harousseau, J. L. ; Simonsson, B. ; Reiffers, J. ; Alessandrino, E. P. ; Hertenstein, B. ; Kolb, H. J. ; Attal, M. ; Vitek, A. ; Sanz, M. A. ; Holowiecki, J. ; Moraleda, J. M. ; Newland, A. C. ; Finke, J. / Stem cell transplantation from identical twins in patients with myelodysplastic syndromes. In: Bone Marrow Transplantation. 2005 ; Vol. 35, No. 1. pp. 37-43.
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abstract = "In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-dentical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P = 0.02) and 16 vs 26 days (P = 0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27{\%}; P = 0.05). The 5 year cumulative incidence of relapse was 32{\%} (95{\%} CI: 29-35{\%}) for the siblings and 39{\%} (95{\%} CI: 26-60{\%}; P = 0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34{\%} (95{\%} CI: 14-54{\%}) Ps 28{\%} (95{\%} CI: 25-31 {\%}; P = 0.2) and 36{\%} (95{\%} CI: 15-57{\%}) vs 32{\%} (95{\%} CI: 29-35{\%}; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95{\%} CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95{\%} CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95{\%} CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.",
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T1 - Stem cell transplantation from identical twins in patients with myelodysplastic syndromes

AU - Kröger, N.

AU - Brand, R.

AU - van Biezen, A.

AU - Bron, D.

AU - Blaise, D.

AU - Hellström-Lindberg, E.

AU - Gahrton, G.

AU - Powles, R.

AU - Littlewood, T.

AU - Chapuis, B.

AU - Zander, A.

AU - Koza, V.

AU - Niederwieser, D.

AU - de Witte, T.

AU - Gratwohl, A.

AU - Barge, R.

AU - Bunjes, D.

AU - Devergie, A.

AU - Harousseau, J. L.

AU - Simonsson, B.

AU - Reiffers, J.

AU - Alessandrino, E. P.

AU - Hertenstein, B.

AU - Kolb, H. J.

AU - Attal, M.

AU - Vitek, A.

AU - Sanz, M. A.

AU - Holowiecki, J.

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AU - Newland, A. C.

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AB - In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-dentical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P = 0.02) and 16 vs 26 days (P = 0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27%; P = 0.05). The 5 year cumulative incidence of relapse was 32% (95% CI: 29-35%) for the siblings and 39% (95% CI: 26-60%; P = 0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34% (95% CI: 14-54%) Ps 28% (95% CI: 25-31 %; P = 0.2) and 36% (95% CI: 15-57%) vs 32% (95% CI: 29-35%; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95% CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95% CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95% CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.

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