PMID- 19059878
OWN - NLM
STAT- MEDLINE
DCOM- 20090501
LR  - 20211020
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 113
IP  - 13
DP  - 2009 Mar 26
TI  - The graft-versus-leukemia effect using matched unrelated donors is not superior 
      to HLA-identical siblings for hematopoietic stem cell transplantation.
PG  - 3110-8
LID - 10.1182/blood-2008-07-163212 [doi]
AB  - Do some patients benefit from an unrelated donor (URD) transplant because of a 
      stronger graft-versus-leukemia (GVL) effect? We analyzed 4099 patients with acute 
      myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic myeloid 
      leukemia (CML) undergoing a myeloablative allogeneic hematopoietic cell 
      transplantation (HCT) from an URD (8/8 human leukocyte antigen [HLA]-matched, 
      n=941) or HLA-identical sibling donor (n=3158) between 1995 and 2004 reported to 
      the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as 
      time-dependent variables. In multivariate analysis, URD transplant recipients had 
      a higher risk for transplantation-related mortality (TRM; relative risk [RR], 
      2.76; P< .001) and relapse (RR, 1.50; P< .002) in patients with AML, but not ALL 
      or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. 
      Leukemia-free survival (LFS) was decreased in patients with AML without acute 
      GVHD receiving a URD transplant (RR, 2.02; P< .001) but was comparable to those 
      receiving HLA-identical sibling transplants in patients with ALL and CML. In 
      patients without GVHD, multivariate analysis showed similar risk of relapse but 
      decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of 
      relapse was the same (ALL, CML) or worse (AML) in URD transplant recipients 
      compared with HLA-identical sibling transplant recipients, suggesting a similar 
      GVL effect.
FAU - Ringden, Olle
AU  - Ringden O
AD  - Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital 
      Huddinge, Stockholm, Sweden. Olle.Ringden@ki.se
FAU - Pavletic, Steven Z
AU  - Pavletic SZ
FAU - Anasetti, Claudio
AU  - Anasetti C
FAU - Barrett, A John
AU  - Barrett AJ
FAU - Wang, Tao
AU  - Wang T
FAU - Wang, Dan
AU  - Wang D
FAU - Antin, Joseph H
AU  - Antin JH
FAU - Di Bartolomeo, Paolo
AU  - Di Bartolomeo P
FAU - Bolwell, Brian J
AU  - Bolwell BJ
FAU - Bredeson, Christopher
AU  - Bredeson C
FAU - Cairo, Mitchell S
AU  - Cairo MS
FAU - Gale, Robert P
AU  - Gale RP
FAU - Gupta, Vikas
AU  - Gupta V
FAU - Hahn, Theresa
AU  - Hahn T
FAU - Hale, Gregory A
AU  - Hale GA
FAU - Halter, Jorg
AU  - Halter J
FAU - Jagasia, Madan
AU  - Jagasia M
FAU - Litzow, Mark R
AU  - Litzow MR
FAU - Locatelli, Franco
AU  - Locatelli F
FAU - Marks, David I
AU  - Marks DI
FAU - McCarthy, Philip L
AU  - McCarthy PL
FAU - Cowan, Morton J
AU  - Cowan MJ
FAU - Petersdorf, Effie W
AU  - Petersdorf EW
FAU - Russell, James A
AU  - Russell JA
FAU - Schiller, Gary J
AU  - Schiller GJ
FAU - Schouten, Harry
AU  - Schouten H
FAU - Spellman, Stephen
AU  - Spellman S
FAU - Verdonck, Leo F
AU  - Verdonck LF
FAU - Wingard, John R
AU  - Wingard JR
FAU - Horowitz, Mary M
AU  - Horowitz MM
FAU - Arora, Mukta
AU  - Arora M
LA  - eng
GR  - R01 CA100019/CA/NCI NIH HHS/United States
GR  - U24 CA076518/CA/NCI NIH HHS/United States
GR  - U24-CA76518/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20081204
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Female
MH  - Follow-Up Studies
MH  - Graft vs Host Disease/epidemiology
MH  - Graft vs Leukemia Effect/*immunology
MH  - HLA Antigens/*immunology
MH  - *Hematopoietic Stem Cell Transplantation/mortality
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Incidence
MH  - Leukemia/immunology/mortality/therapy
MH  - Male
MH  - Middle Aged
MH  - *Siblings
MH  - *Tissue Donors
MH  - Young Adult
PMC - PMC2662650
EDAT- 2008/12/09 09:00
MHDA- 2009/05/02 09:00
PMCR- 2010/03/26
CRDT- 2008/12/09 09:00
PHST- 2008/12/09 09:00 [pubmed]
PHST- 2009/05/02 09:00 [medline]
PHST- 2008/12/09 09:00 [entrez]
PHST- 2010/03/26 00:00 [pmc-release]
AID - S0006-4971(20)39432-5 [pii]
AID - 2008/163212 [pii]
AID - 10.1182/blood-2008-07-163212 [doi]
PST - ppublish
SO  - Blood. 2009 Mar 26;113(13):3110-8. doi: 10.1182/blood-2008-07-163212. Epub 2008 
      Dec 4.