Relative Impact of HLA Matching and Non-HLA Donor Characteristics on Outcomes of Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndrome
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Relative Impact of HLA Matching and Non-HLA Donor Characteristics on Outcomes of Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndrome. / Ayuk, Francis; Beelen, Dietrich W; Bornhäuser, Martin; Stelljes, Matthias; Zabelina, Tatyana; Finke, Jürgen; Kobbe, Guido; Wolff, Daniel; Wagner, Eva-Maria; Christopeit, Maximilian; Schmid, Christoph; Ottinger, Hellmut; Groth, Christoph; Faul, Christoph; Bertz, Hartmut; Rachlis, Elena; Wolschke, Christine; Schetelig, Johannes; Horn, Peter A; Mytilineos, Joannis; Guellstorf, Martina; Kelsch, Reinhard; Fleischhauer, Katharina; Kröger, Nicolaus; Bethge, Wolfgang.
In: BIOL BLOOD MARROW TR, Vol. 24, No. 12, 12.2018, p. 2558-2567.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Relative Impact of HLA Matching and Non-HLA Donor Characteristics on Outcomes of Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndrome
AU - Ayuk, Francis
AU - Beelen, Dietrich W
AU - Bornhäuser, Martin
AU - Stelljes, Matthias
AU - Zabelina, Tatyana
AU - Finke, Jürgen
AU - Kobbe, Guido
AU - Wolff, Daniel
AU - Wagner, Eva-Maria
AU - Christopeit, Maximilian
AU - Schmid, Christoph
AU - Ottinger, Hellmut
AU - Groth, Christoph
AU - Faul, Christoph
AU - Bertz, Hartmut
AU - Rachlis, Elena
AU - Wolschke, Christine
AU - Schetelig, Johannes
AU - Horn, Peter A
AU - Mytilineos, Joannis
AU - Guellstorf, Martina
AU - Kelsch, Reinhard
AU - Fleischhauer, Katharina
AU - Kröger, Nicolaus
AU - Bethge, Wolfgang
N1 - Copyright © 2018. Published by Elsevier Inc.
PY - 2018/12
Y1 - 2018/12
N2 - Increasing donor-recipient HLA disparity is associated with negative outcomes of allogeneic hematopoietic stem cell transplantation (HSCT), but its comparative relevance amid non-HLA donor characteristics is not well established. We addressed this question in 3215 HSCTs performed between 2005 and 2013 in Germany for acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). Donors were HLA-matched related (MRD; n = 872) or unrelated (10/10 MUD, n = 1553) or HLA-mismatched unrelated (<10/10 MMUD, n = 790). Overall survival (OS) was similar after MRD compared with 10/10 MUD HSCT, reflecting opposing hazards of relapse (hazard ratio [HR], 1.32; P < .002) and nonrelapse mortality (HR, .63; P < .001). After UD HSCT, increasing HLA disparity was associated with inferior OS (HR, 1.21 [P < .02] and HR, 1.57 [P < .001] for 9/10 and ≤8/10 MMUD, respectively, compared with 10/10 MUD). Among non-HLA donor characteristics, age, sex mismatching (male recipient-female donor), and cytomegalovirus (CMV) mismatching (positive recipient-negative donor) impacted OS. Multivariate subgroup analysis showed that OS was similar after HSCT from the youngest 9/10 MMUD (<30 years) compared with the oldest 10/10 MUD (>40 years) (HR, 1.18; P = .25) and also in male patients transplanted from female 10/10 MUD compared with male 9/10 MMUD (HR, .89; P = .46). In contrast, OS of CMV-positive patients tended to be better with CMV-negative 10/10 MUDs compared with CMV-positive 9/10 MMUDs (HR, 1.31; P = .04). Because of low patient numbers in subgroups, definite conclusions and establishment of a hierarchy among HLA matching and non-HLA donor characteristics could not be made. Our data suggest that the impact of donor age and sex mismatch but not CMV mismatch on outcome of allogeneic HSCT may be comparable with that of single HLA disparity.
AB - Increasing donor-recipient HLA disparity is associated with negative outcomes of allogeneic hematopoietic stem cell transplantation (HSCT), but its comparative relevance amid non-HLA donor characteristics is not well established. We addressed this question in 3215 HSCTs performed between 2005 and 2013 in Germany for acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). Donors were HLA-matched related (MRD; n = 872) or unrelated (10/10 MUD, n = 1553) or HLA-mismatched unrelated (<10/10 MMUD, n = 790). Overall survival (OS) was similar after MRD compared with 10/10 MUD HSCT, reflecting opposing hazards of relapse (hazard ratio [HR], 1.32; P < .002) and nonrelapse mortality (HR, .63; P < .001). After UD HSCT, increasing HLA disparity was associated with inferior OS (HR, 1.21 [P < .02] and HR, 1.57 [P < .001] for 9/10 and ≤8/10 MMUD, respectively, compared with 10/10 MUD). Among non-HLA donor characteristics, age, sex mismatching (male recipient-female donor), and cytomegalovirus (CMV) mismatching (positive recipient-negative donor) impacted OS. Multivariate subgroup analysis showed that OS was similar after HSCT from the youngest 9/10 MMUD (<30 years) compared with the oldest 10/10 MUD (>40 years) (HR, 1.18; P = .25) and also in male patients transplanted from female 10/10 MUD compared with male 9/10 MMUD (HR, .89; P = .46). In contrast, OS of CMV-positive patients tended to be better with CMV-negative 10/10 MUDs compared with CMV-positive 9/10 MMUDs (HR, 1.31; P = .04). Because of low patient numbers in subgroups, definite conclusions and establishment of a hierarchy among HLA matching and non-HLA donor characteristics could not be made. Our data suggest that the impact of donor age and sex mismatch but not CMV mismatch on outcome of allogeneic HSCT may be comparable with that of single HLA disparity.
KW - Journal Article
U2 - 10.1016/j.bbmt.2018.06.026
DO - 10.1016/j.bbmt.2018.06.026
M3 - SCORING: Journal article
C2 - 29966760
VL - 24
SP - 2558
EP - 2567
JO - BIOL BLOOD MARROW TR
JF - BIOL BLOOD MARROW TR
SN - 1083-8791
IS - 12
ER -
