Prognostic factors affecting outcome after allogeneic transplantation for hematological malignancies from unrelated donors: results from a randomized trial.
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Prognostic factors affecting outcome after allogeneic transplantation for hematological malignancies from unrelated donors: results from a randomized trial. / Finke, Jürgen; Schmoor, Claudia; Bethge, Wolfgang A; Ottinger, Hellmut D; Stelljes, Matthias; Zander, Axel R; Volin, Liisa; Heim, Dominik A; Schwerdtfeger, Rainer; Kolbe, Karin; Mayer, Jiri; Maertens, Johan A; Linkesch, Werner; Holler, Ernst; Koza, Vladimir; Bornhäuser, Martin; Einsele, Hermann; Bertz, Hartmut; Grishina, Olga; Socié, Gérard; ATG-Fresenius Trial Group ; Kröger, Nicolaus-Martin.
in: BIOL BLOOD MARROW TR, Jahrgang 18, Nr. 11, 11, 01.11.2012, S. 1716-1726.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Prognostic factors affecting outcome after allogeneic transplantation for hematological malignancies from unrelated donors: results from a randomized trial.
AU - Finke, Jürgen
AU - Schmoor, Claudia
AU - Bethge, Wolfgang A
AU - Ottinger, Hellmut D
AU - Stelljes, Matthias
AU - Zander, Axel R
AU - Volin, Liisa
AU - Heim, Dominik A
AU - Schwerdtfeger, Rainer
AU - Kolbe, Karin
AU - Mayer, Jiri
AU - Maertens, Johan A
AU - Linkesch, Werner
AU - Holler, Ernst
AU - Koza, Vladimir
AU - Bornhäuser, Martin
AU - Einsele, Hermann
AU - Bertz, Hartmut
AU - Grishina, Olga
AU - Socié, Gérard
AU - ATG-Fresenius Trial Group
AU - Kröger, Nicolaus-Martin
N1 - Copyright © 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
PY - 2012/11/1
Y1 - 2012/11/1
N2 - 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-DRB1, HLA-DQB1 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.
AB - 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-DRB1, HLA-DQB1 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.
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Middle Aged
KW - Adolescent
KW - Severity of Illness Index
KW - Prospective Studies
KW - Age Factors
KW - Survival Rate
KW - Chronic Disease
KW - Histocompatibility Testing
KW - Acute Disease
KW - Transplantation, Homologous
KW - Transplantation Conditioning/methods
KW - Unrelated Donors
KW - Antilymphocyte Serum/therapeutic use
KW - Graft vs Host Disease/etiology/mortality/prevention & control
KW - HLA Antigens/immunology
KW - Hematopoietic Stem Cell Transplantation/adverse effects/mortality
KW - Myeloablative Agonists/therapeutic use
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Middle Aged
KW - Adolescent
KW - Severity of Illness Index
KW - Prospective Studies
KW - Age Factors
KW - Survival Rate
KW - Chronic Disease
KW - Histocompatibility Testing
KW - Acute Disease
KW - Transplantation, Homologous
KW - Transplantation Conditioning/methods
KW - Unrelated Donors
KW - Antilymphocyte Serum/therapeutic use
KW - Graft vs Host Disease/etiology/mortality/prevention & control
KW - HLA Antigens/immunology
KW - Hematopoietic Stem Cell Transplantation/adverse effects/mortality
KW - Myeloablative Agonists/therapeutic use
U2 - 10.1016/j.bbmt.2012.06.001
DO - 10.1016/j.bbmt.2012.06.001
M3 - SCORING: Journal article
C2 - 22713691
VL - 18
SP - 1716
EP - 1726
JO - BIOL BLOOD MARROW TR
JF - BIOL BLOOD MARROW TR
SN - 1083-8791
IS - 11
M1 - 11
ER -
