A retrospective comparison of autologous and unrelated donor hematopoietic cell transplantation in myelodysplastic syndrome and secondary acute myeloid leukemia: a report on behalf of the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT)

被引:29
作者
Al-Ali, H. K.
Brand, R.
van Biezen, A.
Finke, J.
Boogaerts, M.
Fauser, A. A.
Egeler, M.
Cahn, J-Y
Arnold, R.
Biersack, H.
Niederwieser, D.
de Witte, T.
机构
[1] Univ Leipzig, Div Hematol Oncol, D-04103 Leipzig, Germany
[2] Leiden Univ MC, Dept Med Stat, Leiden, Netherlands
[3] Chron Leukemia Working Party Registry, Leiden, Netherlands
[4] Univ Freiburg, Dept Hematol, Freiburg, Germany
[5] Univ Gasthuisberg, Dept Hematol, Louvain, Belgium
[6] Klin Knochenmarktransplantat GmbH, Dept Hematol, Idar Oberstein, Germany
[7] Leiden Univ Hosp, BMT Ctr, Leiden, Netherlands
[8] Hop Jean Minjoz, Serv Hematol, F-25030 Besancon, France
[9] Campus Virchow Klinikum, Charite, Dept Hematol, Berlin, Germany
[10] Univ Essen Gesamthsch, Essen, Germany
[11] Univ St Radboud, Med Ctr, Dept Hematol, Nijmegen, Netherlands
关键词
stem-cell transplantation; myelodysplastic syndrome; secondary acute myeloid leukemia; voluntary unrelated donors;
D O I
10.1038/sj.leu.2404774
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Hematopoietic cell transplantation ( HCT) is an effective treatment for myelodysplasia ( MDS) and secondary acute myeloid leukemia ( sAML). In this study, outcome of 593 patients with MDS/ sAML after autologous and allogeneic HCT from a matched unrelated donor ( MUD) were compared. A total of 167 ( 28%) patients received HCT from MUD without prior chemotherapy ( MUD- U). The rest received HCT in first complete remission ( CR1) ( Autologous ( Auto- CR1), n 290 ( 49%), HCT from MUD ( MUD- CR1), n 136 ( 23%)). Survival at 3 years was best in MUD- CR1 ( 50%) compared to Auto- CR1 ( 41%) and MUDU ( 40%) ( P 0.01). Similarly, disease- free survival was 44% for MUD- CR1 compared to Auto- CR1 ( 28%) and MUD- U ( 34%) ( P 0.03). Treatment- related mortality was 17% in Auto- CR1 compared to MUD- CR1 ( 38%) and MUD- U ( 49%) ( Po0.001). Relapse for Auto- CR1 was 62% compared to 24 and 30% for MUD- CR1 and MUD- U, respectively ( Po0.001). Outcome was best for patients with low tumor burden transplanted 6 - 12 months after diagnosis. Factors influencing outcome at 3 years were mainly significant in the first 6 months. Only, relapse after autologous HCT remained constant over time. Outcomes after allogeneic HCT in patients of 20 - 40 and440 years were similar. Autologous and Allogeneic HCT from MUD offer the possibility of long- term survival to patients with MDS/ sAML.
引用
收藏
页码:1945 / 1951
页数:7
相关论文
共 52 条
[1]   Comparative outcome of nonmyeloablative and myeloablative allogeneic hematopoietic cell transplantation for patients older than 50 years of age [J].
Alyea, EP ;
Kim, HT ;
Ho, V ;
Cutler, C ;
Gribben, J ;
DeAngelo, DJ ;
Lee, SJ ;
Windawi, S ;
Ritz, J ;
Stone, RM ;
Antin, JH ;
Soiffer, RJ .
BLOOD, 2005, 105 (04) :1810-1814
[2]   Stem cell transplantation for secondary acute myeloid leukemia: Evaluation of transplantation as initial therapy or following induction chemotherapy [J].
Anderson, JE ;
Gooley, TA ;
Schoch, G ;
Anasetti, C ;
Bensinger, WI ;
Clift, RA ;
Hansen, JA ;
Sanders, JE ;
Storb, R ;
Appelbaum, FR .
BLOOD, 1997, 89 (07) :2578-2585
[3]   AN UPDATE ON ALLOGENEIC MARROW TRANSPLANTATION FOR MYELODYSPLASTIC SYNDROME [J].
ANDERSON, JE ;
APPELBAUM, FR ;
STORB, R .
LEUKEMIA & LYMPHOMA, 1995, 17 (1-2) :95-99
[4]  
Anderson JE, 1996, BLOOD, V87, P51
[5]  
Appelbaum FR, 1998, LEUKEMIA, V12, pS25
[6]  
ARMITAGE JO, 1981, CANCER TREAT REP, V65, P601
[7]   Unrelated bone marrow transplantation in patients with myelodysplastic syndromes and secondary acute myeloid leukemia: an EBMT survey [J].
Arnold, R ;
de Witte, T ;
van Biezen, A ;
Hermans, J ;
Jacobsen, N ;
Runde, V ;
Gratwohl, A ;
Apperley, JF .
BONE MARROW TRANSPLANTATION, 1998, 21 (12) :1213-1216
[8]   Successful peripheral blood stem cell transplantation for myelodysplastic syndrome [J].
Ashihara, E ;
Shimazaki, C ;
Okamoto, A ;
Shimura, K ;
Takahashi, R ;
Sumikuma, T ;
Hirai, H ;
Inaba, T ;
Fujita, N ;
Nakagawa, M .
BONE MARROW TRANSPLANTATION, 1999, 24 (12) :1343-1345
[9]   AGE-RELATED INCIDENCE AND OTHER EPIDEMIOLOGIC ASPECTS OF MYELODYSPLASTIC SYNDROMES [J].
AUL, C ;
GATTERMANN, N ;
SCHNEIDER, W .
BRITISH JOURNAL OF HAEMATOLOGY, 1992, 82 (02) :358-367
[10]   PROPOSALS FOR THE CLASSIFICATION OF THE MYELODYSPLASTIC SYNDROMES [J].
BENNETT, JM ;
CATOVSKY, D ;
DANIEL, MT ;
FLANDRIN, G ;
GALTON, DAG ;
GRALNICK, HR ;
SULTAN, C .
BRITISH JOURNAL OF HAEMATOLOGY, 1982, 51 (02) :189-199