Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial

被引：56

作者：

Finke, Juergen ^{[1
]}

Schmoor, Claudia ^{[2
]}

Bethge, Wolfgang A. ^{[3
]}

Ottinger, Hellmut D. ^{[4
]}

Stelljes, Matthias ^{[5
]}

Zander, Axel R. ^{[6
]}

Volin, Liisa ^{[7
]}

Heim, Dominik A. ^{[8
]}

Schwerdtfeger, Rainer ^{[9
]}

Kolbe, Karin ^{[10
]}

Mayer, Jiri ^{[11
,12
]}

Maertens, Johan A. ^{[13
]}

Linkesch, Werner ^{[14
]}

Holler, Ernst ^{[15
]}

Koza, Vladimir ^{[16
]}

Bornhaeuser, Martin ^{[17
]}

Einsele, Hermann ^{[18
]}

Bertz, Hartmut ^{[1
]}

Grishina, Olga ^{[2
]}

Socie, Gerard ^{[19
]}

机构：

[1] Univ Freiburg Klinikum, Dept Hematol & Oncol, Freiburg, Germany

[2] Univ Freiburg Klinikum, Clin Trials Unit, Freiburg, Germany

[3] Univ Klinikum Tubingen, Dept Hematol & Oncol, Tubingen, Germany

[4] Univ Klinikum Essen, Klin & Poliklin KMT, Essen, Germany

[5] Univ Klin Munster, Dept Hematol & Oncol, Munster, Germany

[6] Univ Klinikum Hamburg Eppendorf, Dept Internal Med, Hamburg, Germany

[7] Univ Helsinki, Cent Hosp, Dept Med, Helsinki, Finland

[8] Univ Spital Basel, Dept Hematol, Basel, Switzerland

[9] Stiftung Deutsch Klin Diagnost, Ctr Blood & Bone Marrow Transplantat, Wiesbaden, Germany

[10] Johannes Gutenberg Univ Mainz, Dept Internal Med, Univ Med, D-6500 Mainz, Germany

[11] Univ Hosp Brno, Dept Internal Med Hematol & Oncol, Brno, Czech Republic

[12] Masaryk Univ, Brno, Czech Republic

[13] IK UZ Gasthuisberg, Dept Hematol, Louvain, Belgium

[14] Univ Klinikum Graz, Dept Hematol, Graz, Austria

[15] Klinikum Univ Regensburg, Dept Hematol & Oncol, Regensburg, Germany

[16] Charles Univ Hosp, Dept Hematol & Oncol, Plzen, Czech Republic

[17] Univ Klinikum Carl Gustav Carus, Ctr Bone Marrow Transplantat, Dresden, Germany

[18] Univ Klin Wurzburg, Med Klin & Poliklin 2, Wurzburg, Germany

[19] Hop St Louis, Serv Hematol Greffe de Moelle, Paris, France

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2012年 / 18卷 / 11期

关键词：

Allogeneic hematopoietic stem-cell transplantation; Graft-versus-host-disease prophylaxis; HLA-matching; VERSUS-HOST-DISEASE; HEMATOPOIETIC-CELL TRANSPLANTATION; ACUTE MYELOID-LEUKEMIA; LONG-TERM SURVIVAL; RISK-FACTORS; BONE-MARROW; PROPHYLAXIS; GLOBULIN; RECIPIENT; GRAFTS;

D O I：

10.1016/j.bbmt.2012.06.001

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Several prognostic factors for the outcome after allogeneic hematopoietic stem-cell transplant (HSCT) from matched unrelated donors have been postulated from registry data; however, data from randomized trials are lacking. We present analyses on the effects of patient-related, donor-related, and treatment-related prognostic factors on acute GVHD (aGVHD), chronic GVHD (cGVHD), relapse, nonrelapse mortality (NRM), disease-free survival (DFS), and overall survival (OS) in a randomized, multicenter, open-label, phase III trial comparing standard graft-versus-host-disease (GVHD) prophylaxis with and without pretransplantation ATG-Fresenius (ATG-F) in 201 adult patients receiving myeloablative conditioning before HSCT from HLA-A, HLA-B antigen, HLA-DRBI, HLA-DQBI allele matched unrelated donors. High-resolution testing (allele) of HLA-A, HLA-B, and HLA-C were obtained after study closure, and the impact of an HLA 10/10 4-digit mismatch on outcome and on the treatment effect of ATG-F versus control investigated. Advanced disease was a negative factor for relapse, DFS, and OS. Donor age >= 40 adversely affected the risk of aGVHD III-IV, extensive cGVHD, and OS. Younger donors are to be preferred in unrelated donor transplantation. Advanced disease patients need special precautions to improve outcome. The degree of mismatch had no major influence on the positive effect of ATG-F on the reduction of aGVHD and cGVHD. Biol Blood Marrow Transplant 18: 1716-1726 (2012) (C) 2012 American Society for Blood and Marrow Transplantation

引用

页码：1716 / 1726

页数：11

共 31 条

[1]

Anasetti C, 2011, BLOOD, V118, P3

[2] HLA-Identical Sibling Compared With 8/8 Matched and Mismatched Unrelated Donor Bone Marrow Transplant for Chronic Phase Chronic Myeloid Leukemia [J].

Arora, Mukta ;

Weisdorf, Daniel J. ;

Spellman, Stephen R. ;

Haagenson, Michael D. ;

Klein, John P. ;

Hurley, Carolyn K. ;

Selby, George B. ;

Antin, Joseph H. ;

Kernan, Nancy A. ;

Kollman, Craig ;

Nademanee, Auayporn ;

McGlave, Philip ;

Horowitz, Mary M. ;

Petersdorf, Effie W. .

JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (10) :1644-1652

[3] Antithymocyte globulin for graft-versus-host disease prophylaxis in transplants from unrelated donors: 2 randomized studies from Gruppo Italiano Trapianti Midollo Osseo (GITMO) [J].

Bacigalupo, A ;

Lamparelli, T ;

Bruzzi, P ;

Guidi, S ;

Alessandrino, PE ;

di Bartolomeo, P ;

Oneto, R ;

Bruno, B ;

Barbanti, M ;

Sacchi, N ;

Van Lint, MT ;

Bosi, A .

BLOOD, 2001, 98 (10) :2942-2947

[4] The EBMT activity survey 2009: trends over the past 5 years [J].

Baldomero, H. ;

Gratwohl, M. ;

Gratwohl, A. ;

Tichelli, A. ;

Niederwieser, D. ;

Madrigal, A. ;

Frauendorfer, K. .

BONE MARROW TRANSPLANTATION, 2011, 46 (04) :485-501

[5] Factors predicting outcome after unrelated donor stem cell transplantation in primary refractory acute myeloid leukaemia [J].

Craddock, C. ;

Labopin, M. ;

Pillai, S. ;

Finke, J. ;

Bunjes, D. ;

Greinix, H. ;

Ehninger, G. ;

Steckel, N-K ;

Zander, A. R. ;

Schwerdtfeger, R. ;

Buchholz, S. ;

Kolb, H-J ;

Volin, L. ;

Fauser, A. ;

Polge, E. ;

Schmid, C. ;

Mohty, M. ;

Rocha, V. .

LEUKEMIA, 2011, 25 (05) :808-813

[6] Factors predicting long-term survival after T-cell depleted reduced intensity allogeneic stem cell transplantation for acute myeloid leukemia [J].

Craddock, Charles ;

Nagra, Sandeep ;

Peniket, Andrew ;

Brookes, Cassandra ;

Buckley, Laura ;

Nikolousis, Emmanouil ;

Duncan, Nick ;

Tauro, Sudhir ;

Yin, John ;

Liakopoulou, Effie ;

Kottaridis, Panos ;

Snowden, John ;

Milligan, Donald ;

Cook, Gordon ;

Tholouli, Beni ;

Littlewood, Tint ;

Peggs, Karl ;

Vyas, Paresh ;

Clark, Fiona ;

Cook, Mark ;

MacKinnon, Stephen ;

Russell, Nigel .

HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, 2010, 95 (06) :989-995

[7] Unrelated Donor Hematopoietic Cell Transplantation: Factors Associated with a Better HLA Match [J].

Dehn, Jason ;

Arora, Mukta ;

Spellman, Stephen ;

Setterholm, Michelle ;

Horowitz, Mary ;

Confer, Dennis ;

Weisdorf, Daniel .

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2008, 14 (12) :1334-1340

[8] Peripheral blood grafts from unrelated donors are associated with increased acute and chronic graft-versus-host disease without improved survival [J].

Eapen, Mary ;

Logan, Brent R. ;

Confer, Dennis L. ;

Haagenson, Michael ;

Wagner, John E. ;

Weisdorf, Daniel J. ;

Wingard, John R. ;

Rowley, Scott D. ;

Stroncek, David ;

Gee, Adrian P. ;

Horowitz, Mary M. ;

Anasetti, Claudio .

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2007, 13 (12) :1461-1468

[9] Standard graft-versus-host disease prophylaxis with or without anti-T-cell globulin in haematopoietic cell transplantation from matched unrelated donors: a randomised, open-label, multicentre phase 3 trial [J].

Finke, Juergen ;

Bethge, Wolfgang A. ;

Schmoor, Claudia ;

Ottinger, Hellmut D. ;

Stelljes, Matthias ;

Zander, Axel R. ;

Volin, Liisa ;

Ruutu, Tapani ;

Heim, Dominik A. ;

Schwerdtfeger, Rainer ;

Kolbe, Karin ;

Mayer, Jiri ;

Maertens, Johan A. ;

Linkesch, Werner ;

Holler, Ernst ;

Koza, Vladimir ;

Bornhaeuser, Martin ;

Einsele, Hermann ;

Kolb, Hans-Jochem ;

Bertz, Hartmut ;

Egger, Matthias ;

Grishina, Olga ;

Socie, Gerard .

LANCET ONCOLOGY, 2009, 10 (09) :855-864

[10] Comparative analysis of risk factors for acute graft-versus-host disease and for chronic graft-versus-host disease according to National Institutes of Health consensus criteria [J].

Flowers, Mary E. D. ;

Inamoto, Yoshihiro ;

Carpenter, Paul A. ;

Lee, Stephanie J. ;

Kiem, Hans-Peter ;

Petersdorf, Effie W. ;

Pereira, Shalini E. ;

Nash, Richard A. ;

Mielcarek, Marco ;

Fero, Matthew L. ;

Warren, Edus H. ;

Sanders, Jean E. ;

Storb, Rainer F. ;

Appelbaum, Frederick R. ;

Storer, Barry E. ;

Martin, Paul J. .

BLOOD, 2011, 117 (11) :3214-3219

← 1 2 3 4 →