PMID- 24767157
OWN - NLM
STAT- MEDLINE
DCOM- 20150212
LR  - 20140428
IS  - 0578-1426 (Print)
IS  - 0578-1426 (Linking)
VI  - 53
IP  - 2
DP  - 2014 Feb
TI  - [The clinical analysis of allogeneic hematopoietic stem cell transplantation from 
      human leukocyte antigen-identical siblings in 95 patients with myelodysplastic 
      syndrome].
PG  - 89-93
AB  - OBJECTIVE: To evaluate the efficacy and optimize the timing of allogeneic 
      hematopoietic stem cell transplantation (allo-HSCT) from human leukocyte antigen 
      (HLA)-identical siblings for myelodysplastic syndrome (MDS). METHODS: From 
      January 2003 to December 2012, 95 patients with MDS or secondary acute myeloid 
      leukemia (AML) were treated with HLA-identical allo-HSCT in our hospital. The 
      median age was 43 (21-59) years. Conditioning regimens including modified 
      busulfan (Bu)/cyclophosphamide (Cy) or Bu/ fludarabine (Flu) were used. All 
      patients received transfusion of donor stem cells mobilized by granulocyte 
      colony-stimulating factor (G-CSF) from bone marrow and/or peripheral blood. 
      Eleven patients had refractory anemia (RA) or RA with ringed sideroblasts, 53 of 
      RA with excess blasts (RAEB), 15 of RAEB in transformation (RAEB-t), and 16 
      progressing to secondary AML. RESULTS: A total of 93 patients achieved sustained 
      myeloid engraftment. The cumulative incidence of grade II-IV acute graft versus 
      host disease (aGVHD) was 12.9% +/- 3.5%. The 3-year cumulative incidence of chronic 
      graft versus host disease (cGVHD) was 80.3% +/- 4.9%. After a median follow-up of 
      28.7 months, 29 patients died. The 3-year estimated overall survival (OS) and 
      disease-free survival (DFS) rates were 69.9% +/- 5.0% and 58.0% +/- 5.4% 
      respectively. The cumulative relapse rate (RR) was 25.9% +/- 4.7%, while 
      non-relapse mortality (NRM) was 16.1% +/- 4.0%. Multivariate analyses showed that 
      non II-IV aGVHD and cGVHD were favorable factors associated with OS. Low DFS rate 
      was correlated with high scores of international prognostic scoring system 
      (IPSS). Patients with RAEB-t and AML (n = 31) were divided into 3 groups: no 
      chemotherapy before HSCT (Group 1), chemotherapy but not achieving remission 
      (Group 2) and chemotherapy and achieving remission (Group 3). The 3-year OS rate 
      was 100.0% in Group 3, which was significantly higher than those of Groups 1 and 
      2 with 33.9%, 32.7% respectively (P < 0.05). The difference of DFS and RR in the 
      three groups did not reach statistic difference. CONCLUSIONS: Allo-HSCT from 
      HLA-identical siblings is effective for patients with MDS. IPSS is of prognostic 
      value for post-transplantation outcome. For patients with progressive disease 
      before transplantation, maximal control of blasts in bone marrow may improve the 
      prognosis of advanced MDS.
FAU - Zhao, Ting
AU  - Zhao T
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Huang, Xiaojun
AU  - Huang X
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Liu, Daihong
AU  - Liu D
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Wang, Jingzhi
AU  - Wang J
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Zhang, Xiaohui
AU  - Zhang X
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Wang, Yu
AU  - Wang Y
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Han, Wei
AU  - Han W
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Chen, Huan
AU  - Chen H
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Chen, Yuhong
AU  - Chen Y
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Wang, Fengrong
AU  - Wang F
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Liu, Kaiyan
AU  - Liu K
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China.
FAU - Xu, Lanping
AU  - Xu L
AD  - Peking University Institute of Hematology, the People's Hospital, Peking 
      University, Beijing 100044, China. Email: lpxu_0415@sina.com.
LA  - chi
PT  - English Abstract
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Zhonghua Nei Ke Za Zhi
JT  - Zhonghua nei ke za zhi
JID - 16210490R
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Disease-Free Survival
MH  - Female
MH  - HLA Antigens
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myelodysplastic Syndromes/*therapy
MH  - Retrospective Studies
MH  - *Siblings
MH  - Survival Rate
MH  - Tissue Donors
MH  - Transplantation, Homologous
MH  - Young Adult
EDAT- 2014/04/29 06:00
MHDA- 2015/02/13 06:00
CRDT- 2014/04/29 06:00
PHST- 2014/04/29 06:00 [entrez]
PHST- 2014/04/29 06:00 [pubmed]
PHST- 2015/02/13 06:00 [medline]
PST - ppublish
SO  - Zhonghua Nei Ke Za Zhi. 2014 Feb;53(2):89-93.