PMID- 21620989
OWN - NLM
STAT- MEDLINE
DCOM- 20120522
LR  - 20220321
IS  - 1523-6536 (Electronic)
IS  - 1083-8791 (Linking)
VI  - 17
IP  - 11
DP  - 2011 Nov
TI  - Improved survival after allogeneic hematopoietic stem cell transplantation in 
      recent years. A single-center study.
PG  - 1688-97
LID - 10.1016/j.bbmt.2011.05.001 [doi]
AB  - We analyzed the outcome of allogeneic hematopoietic stem cell transplantation 
      (HSCT) over the past 2 decades. Between 1992 and 2009, 953 patients were treated 
      with HSCT, mainly for a hematologic malignancy. They were divided according to 4 
      different time periods of treatment: 1992 to 1995, 1996 to 2000, 2001 to 2005, 
      and 2006 to 2009. Over the years, many factors have changed considerably 
      regarding patient age, diagnosis, disease stage, type of donor, stem cell source, 
      genomic HLA typing, cell dose, type of conditioning, treatment of infections, use 
      of granulocyte-colony stimulating factor (G-CSF), use of mesenchymal stem cells, 
      use of cytotoxic T cells, and home care. When we compared the last period 
      (2006-2009) with earlier periods, we found slower neutrophil engraftment, a 
      higher incidence of acute graft-versus-host disease (aGVHD) of grades II-IV, and 
      less chronic GVHD (cGHVD). The incidence of relapse was unchanged over the 4 
      periods (22%-25%). Overall survival (OS) and transplant-related mortality (TRM) 
      improved significantly in the more recent periods, with the best results during 
      the last period (2006-2009) and a 100-day TRM of 5.5%. This improvement was also 
      apparent in a multivariate analysis. When correcting for differences between the 
      4 groups, the hazard ratio for mortality in the last period was 0.59 (95% 
      confidence interval [CI]: 0.44-0.79; P < .001) and for TRM it was 0.63 (CI: 
      0.43-0.92; P = .02). This study shows that the combined efforts to improve 
      outcome after HSCT have been very effective. Even though we now treat older 
      patients with more advanced disease and use more alternative HLA nonidentical 
      donors, OS and TRM have improved. The problem of relapse still has to be 
      remedied. Thus, several different developments together have resulted in 
      significantly lower TRM and improved survival after HSCT over the last few years.
CI  - Copyright (c) 2011 American Society for Blood and Marrow Transplantation. Published 
      by Elsevier Inc. All rights reserved.
FAU - Remberger, Mats
AU  - Remberger M
AD  - Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital 
      Huddinge, Karolinska Institutet, Stockholm, Sweden. mats.remberger@ki.se
FAU - Ackefors, Malin
AU  - Ackefors M
FAU - Berglund, Sofia
AU  - Berglund S
FAU - Blennow, Ola
AU  - Blennow O
FAU - Dahllof, Goran
AU  - Dahllof G
FAU - Dlugosz, Aldona
AU  - Dlugosz A
FAU - Garming-Legert, Karin
AU  - Garming-Legert K
FAU - Gertow, Jens
AU  - Gertow J
FAU - Gustafsson, Britt
AU  - Gustafsson B
FAU - Hassan, Moustapha
AU  - Hassan M
FAU - Hassan, Zuzana
AU  - Hassan Z
FAU - Hauzenberger, Dan
AU  - Hauzenberger D
FAU - Hagglund, Hans
AU  - Hagglund H
FAU - Karlsson, Helen
AU  - Karlsson H
FAU - Klingspor, Lena
AU  - Klingspor L
FAU - Kumlien, Gunilla
AU  - Kumlien G
FAU - Le Blanc, Katarina
AU  - Le Blanc K
FAU - Ljungman, Per
AU  - Ljungman P
FAU - Machaczka, Maciej
AU  - Machaczka M
FAU - Malmberg, Karl-Johan
AU  - Malmberg KJ
FAU - Marschall, Hanns-Ulrich
AU  - Marschall HU
FAU - Mattsson, Jonas
AU  - Mattsson J
FAU - Olsson, Richard
AU  - Olsson R
FAU - Omazic, Brigitta
AU  - Omazic B
FAU - Sairafi, Darius
AU  - Sairafi D
FAU - Schaffer, Marie
AU  - Schaffer M
FAU - Svahn, Britt-Marie
AU  - Svahn BM
FAU - Svenberg, Petter
AU  - Svenberg P
FAU - Swartling, Lisa
AU  - Swartling L
FAU - Szakos, Attila
AU  - Szakos A
FAU - Uhlin, Michael
AU  - Uhlin M
FAU - Uzunel, Mehmet
AU  - Uzunel M
FAU - Watz, Emma
AU  - Watz E
FAU - Wernerson, Annika
AU  - Wernerson A
FAU - Wikman, Agneta
AU  - Wikman A
FAU - Wikstrom, Ann-Charlotte
AU  - Wikstrom AC
FAU - Winiarski, Jacek
AU  - Winiarski J
FAU - Ringden, Olle
AU  - Ringden O
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110511
PL  - United States
TA  - Biol Blood Marrow Transplant
JT  - Biology of blood and marrow transplantation : journal of the American Society for 
      Blood and Marrow Transplantation
JID - 9600628
SB  - IM
CIN - Pediatr Transplant. 2016 Aug;20(5):667-74. PMID: 27251184
MH  - Adult
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Disease-Free Survival
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation/methods/*mortality
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Middle Aged
MH  - Survival Analysis
MH  - Sweden/epidemiology
MH  - Tissue Donors
MH  - Transplantation, Homologous/methods/mortality
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2011/05/31 06:00
MHDA- 2012/05/23 06:00
CRDT- 2011/05/31 06:00
PHST- 2011/03/07 00:00 [received]
PHST- 2011/05/03 00:00 [accepted]
PHST- 2011/05/31 06:00 [entrez]
PHST- 2011/05/31 06:00 [pubmed]
PHST- 2012/05/23 06:00 [medline]
AID - S1083-8791(11)00207-2 [pii]
AID - 10.1016/j.bbmt.2011.05.001 [doi]
PST - ppublish
SO  - Biol Blood Marrow Transplant. 2011 Nov;17(11):1688-97. doi: 
      10.1016/j.bbmt.2011.05.001. Epub 2011 May 11.