PMID- 20371745
OWN - NLM
STAT- MEDLINE
DCOM- 20100709
LR  - 20220318
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Linking)
VI  - 115
IP  - 25
DP  - 2010 Jun 24
TI  - HLA-mismatched unrelated donors are a viable alternate graft source for 
      allogeneic transplantation following alemtuzumab-based reduced-intensity 
      conditioning.
PG  - 5147-53
LID - 10.1182/blood-2010-01-265413 [doi]
AB  - The impact of human leukocyte antigen (HLA) mismatch after reduced-intensity 
      conditioning allogeneic hematopoietic stem cell transplantation (RIT) using 
      unrelated donors (UD) is unclear, and may be modulated by T-cell depletion. We 
      therefore examined outcomes of 157 consecutive patients undergoing RIT after 
      uniform conditioning with fludarabine, melphalan, and alemtuzumab (FMC). Donors 
      were 10/10 HLA-matched (MUDs, n = 107) and 6 to 9/10 HLA-matched (MMUDs, n = 50), 
      with no significant differences in baseline characteristics other than increased 
      cytomegalovirus seropositivity in MMUDs. Rates of durable engraftment were high. 
      Graft failure rates (persistent cytopenias with donor chimerism) were similar (8% 
      vs 3%, P = .21), though rejection (recipient chimerism) was more frequent in 
      MMUDs (8% vs 0%, P < .01). There were no significant differences between donors 
      in the incidences of acute graft-versus-host disease (GVHD; 20% vs 22% grade 2-4, 
      respectively, P = .83), chronic extensive GVHD (3-year cumulative incidence [CI] 
      23% vs 24%, P = .56), or treatment-related mortality (1-year CI 27% vs 27%, P = 
      .96). Furthermore, there was no difference in 3-year overall survival (OS; 53% vs 
      49%, P = .44). Mismatch occurred at the antigenic level in 40 cases. The outcome 
      in these cases did not differ significantly from the rest of the cohort. We 
      conclude that RIT using HLA-mismatched grafts is a viable option using FMC 
      conditioning.
FAU - Mead, Adam J
AU  - Mead AJ
AD  - Department of Haematology, University College London (UCL) Medical School, 
      London, United Kingdom.
FAU - Thomson, Kirsty J
AU  - Thomson KJ
FAU - Morris, Emma C
AU  - Morris EC
FAU - Mohamedbhai, Sajir
AU  - Mohamedbhai S
FAU - Denovan, Shari
AU  - Denovan S
FAU - Orti, Guillermo
AU  - Orti G
FAU - Fielding, Adele K
AU  - Fielding AK
FAU - Kottaridis, Panagiotis D
AU  - Kottaridis PD
FAU - Hough, Rachael
AU  - Hough R
FAU - Chakraverty, Ronjon
AU  - Chakraverty R
FAU - Linch, David C
AU  - Linch DC
FAU - Mackinnon, Stephen
AU  - Mackinnon S
FAU - Peggs, Karl S
AU  - Peggs KS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100406
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antibodies, Neoplasm)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (HLA Antigens)
RN  - 0 (Myeloablative Agonists)
RN  - 3A189DH42V (Alemtuzumab)
RN  - FA2DM6879K (Vidarabine)
RN  - P2K93U8740 (fludarabine)
RN  - Q41OR9510P (Melphalan)
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Alemtuzumab
MH  - Antibodies, Monoclonal
MH  - Antibodies, Monoclonal, Humanized
MH  - Antibodies, Neoplasm
MH  - Antineoplastic Agents/*administration & dosage
MH  - Chronic Disease
MH  - Disease-Free Survival
MH  - Female
MH  - Graft Rejection/mortality
MH  - Graft Survival/drug effects
MH  - Graft vs Host Disease/mortality/therapy
MH  - *HLA Antigens
MH  - Hematologic Neoplasms/*mortality/*therapy
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Incidence
MH  - *Living Donors
MH  - Lymphocyte Depletion/methods
MH  - Male
MH  - Melphalan/administration & dosage
MH  - Middle Aged
MH  - Myeloablative Agonists/administration & dosage
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Time Factors
MH  - Transplantation Chimera
MH  - *Transplantation Conditioning
MH  - Transplantation, Homologous
MH  - Vidarabine/administration & dosage/analogs & derivatives
EDAT- 2010/04/08 06:00
MHDA- 2010/07/10 06:00
CRDT- 2010/04/08 06:00
PHST- 2010/04/08 06:00 [entrez]
PHST- 2010/04/08 06:00 [pubmed]
PHST- 2010/07/10 06:00 [medline]
AID - S0006-4971(20)34833-3 [pii]
AID - 10.1182/blood-2010-01-265413 [doi]
PST - ppublish
SO  - Blood. 2010 Jun 24;115(25):5147-53. doi: 10.1182/blood-2010-01-265413. Epub 2010 
      Apr 6.