Allogeneic stem cell transplantation for older advanced MDS patients: improved survival with young unrelated donor in comparison with HLA-identical siblings.
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Allogeneic stem cell transplantation for older advanced MDS patients: improved survival with young unrelated donor in comparison with HLA-identical siblings. / Kröger, Nicolaus; Zabelina, Tatiana; de Wreede, L; Berger, Juergen; Alchalby, Haefaa; van Biezen, A; Milpied, N; Volin, L; Mohty, M; Leblond, V; Blaise, D; Finke, J; Schaap, N; Robin, M; de Witte, T; European Group for Blood and Marrow Transplantation.
In: LEUKEMIA, Vol. 27, No. 3, 3, 2013, p. 604-609.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Allogeneic stem cell transplantation for older advanced MDS patients: improved survival with young unrelated donor in comparison with HLA-identical siblings.
AU - Kröger, Nicolaus
AU - Zabelina, Tatiana
AU - de Wreede, L
AU - Berger, Juergen
AU - Alchalby, Haefaa
AU - van Biezen, A
AU - Milpied, N
AU - Volin, L
AU - Mohty, M
AU - Leblond, V
AU - Blaise, D
AU - Finke, J
AU - Schaap, N
AU - Robin, M
AU - de Witte, T
AU - European Group for Blood and Marrow Transplantation
PY - 2013
Y1 - 2013
N2 - We investigated whether a young human leukocyte antigen (HLA)-matched unrelated donor (MUD) should be preferred as donor to an HLA-identical sibling (MRD) for older patients with myelodysplastic syndrome (MDS) (? 50 years) who underwent allogeneic stem cell transplantation (AHSCT). Outcomes of 719 MDS patients with a median age of 58 years (range, 50-73 years) who received AHSCT from related (n=555) or unrelated (n=164) donors between 1999 and 2008 and reported to the European Group for Blood and Marrow Transplantation were analyzed. The median donor age of the MRD was 56 years (range: 35-78), in contrast to 34 years (range: 19-64) for the MUDs. Influence of donor's age on survival was not observed for MRD (hazard ratio (HR): 1.01 (95% confidence interval (CI): 0.99-1.02), P=0.2), but there was a significant impact of MUD's age on outcome (HR: 1.03 (95% CI: 1.01-1.06); P=0.02). Transplantation from younger MUDs (<30 years) had a significant improved 5-year overall survival in comparison with MRD and older MUDs (>30 years): 40% vs 33% vs 24% (P=0.04). In a multivariate analysis, AHSCT from young MUD (<30 years) remained a significant factor for improved survival in comparison with MRD (HR: 0.65 (95% CI: 0.45-0.95), P=0.03), which should be considered in donor selection for older patients.
AB - We investigated whether a young human leukocyte antigen (HLA)-matched unrelated donor (MUD) should be preferred as donor to an HLA-identical sibling (MRD) for older patients with myelodysplastic syndrome (MDS) (? 50 years) who underwent allogeneic stem cell transplantation (AHSCT). Outcomes of 719 MDS patients with a median age of 58 years (range, 50-73 years) who received AHSCT from related (n=555) or unrelated (n=164) donors between 1999 and 2008 and reported to the European Group for Blood and Marrow Transplantation were analyzed. The median donor age of the MRD was 56 years (range: 35-78), in contrast to 34 years (range: 19-64) for the MUDs. Influence of donor's age on survival was not observed for MRD (hazard ratio (HR): 1.01 (95% confidence interval (CI): 0.99-1.02), P=0.2), but there was a significant impact of MUD's age on outcome (HR: 1.03 (95% CI: 1.01-1.06); P=0.02). Transplantation from younger MUDs (<30 years) had a significant improved 5-year overall survival in comparison with MRD and older MUDs (>30 years): 40% vs 33% vs 24% (P=0.04). In a multivariate analysis, AHSCT from young MUD (<30 years) remained a significant factor for improved survival in comparison with MRD (HR: 0.65 (95% CI: 0.45-0.95), P=0.03), which should be considered in donor selection for older patients.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Young Adult
KW - Prognosis
KW - Survival Rate
KW - Follow-Up Studies
KW - Transplantation, Homologous
KW - Siblings
KW - Stem Cell Transplantation
KW - Donor Selection
KW - HLA Antigens/metabolism
KW - Myelodysplastic Syndromes/immunology/mortality/therapy
KW - Neoplasm Recurrence, Local/immunology/mortality/therapy
KW - Unrelated Donors
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Young Adult
KW - Prognosis
KW - Survival Rate
KW - Follow-Up Studies
KW - Transplantation, Homologous
KW - Siblings
KW - Stem Cell Transplantation
KW - Donor Selection
KW - HLA Antigens/metabolism
KW - Myelodysplastic Syndromes/immunology/mortality/therapy
KW - Neoplasm Recurrence, Local/immunology/mortality/therapy
KW - Unrelated Donors
M3 - SCORING: Journal article
VL - 27
SP - 604
EP - 609
JO - LEUKEMIA
JF - LEUKEMIA
SN - 0887-6924
IS - 3
M1 - 3
ER -
