PMID- 30456421
OWN - NLM
STAT- MEDLINE
DCOM- 20190128
LR  - 20190128
IS  - 1432-0584 (Electronic)
IS  - 0939-5555 (Linking)
VI  - 98
IP  - 2
DP  - 2019 Feb
TI  - Utility of allogeneic hematopoietic stem cell transplantation using international 
      donors in a homogenous ethnic population: question in the era of various 
      alternative donors.
PG  - 501-510
LID - 10.1007/s00277-018-3550-z [doi]
AB  - The advent of various alternative donors in allogeneic hematopoietic stem cell 
      transplantation (HSCT) raises the question of using international donors, 
      especially in ethnically homogenous populations. We analyzed the clinical outcome 
      and medical expense of human leukocyte antigen (HLA)-matched HSCT using domestic 
      and international donors. We analyzed the patients who received allogeneic HSCT 
      at five medical centers in Korea in the last 10 years. Using propensity-score 
      matching, we compared overall survival (OS), relapse-free survival (RFS), and 
      transplantation-related complications. Medical expense was analyzed based on 
      National Health Insurance Service (NHIS) data. A total of 269 patients were 
      analyzed after 3:1 (domestic/international) matching. There was no difference in 
      OS (p = 0.395) and RFS (p = 0.604) between the domestic and international donor 
      groups (5-year OS rate 42.9 and 37.8%, 5-year RFS rate 37.6 and 33.5% for 
      domestic and international groups, respectively). No difference in chronic 
      graft-versus-host disease (GVHD) incidence was observed (34.2% in domestic and 
      35.9% in international group, p = 0.804). Early infection was more frequent in 
      the domestic group (55.0 vs. 35.8%, p = 0.007), whereas infection after 30 days 
      was more frequent in the international group (28.7 vs. 49.3%, p = 0.001). Mean 
      medical expense was far higher in the international group, by US $51,944 in the 
      entire follow-up period (p < 0.001). We would expect similar outcomes for 
      international and domestic donors in terms of survival and treatment-related 
      complications with HLA-matched HSCT in other ethnically homogenous populations. 
      These findings should be considered together with the high cost of using 
      international donors in the era of various alternative donors.
FAU - Kim, Sang-A
AU  - Kim SA
AD  - Department of Internal Medicine, Seoul National University Hospital, Seoul, South 
      Korea.
FAU - Lee, Jayoun
AU  - Lee J
AD  - National Evidence-based healthcare Collaborating Agency, Seoul, South Korea.
FAU - Moon, Joon Ho
AU  - Moon JH
AD  - Department of Internal Medicine, Kyungpook National University Hospital, Daegu, 
      South Korea.
FAU - Lee, Hyewon
AU  - Lee H
AD  - Department of Internal Medicine, National Cancer Center, Goyang, South Korea.
FAU - Jang, Junho
AU  - Jang J
AD  - Department of Internal Medicine, Sungkyunkwan University School of Medicine, 
      Seoul, South Korea.
FAU - Cheong, June-Won
AU  - Cheong JW
AD  - Department of Internal Medicine, Yonsei University College of Medicine, Seoul, 
      South Korea.
FAU - Youk, Jeonghwan
AU  - Youk J
AD  - Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
FAU - Choi, Yeonjoo
AU  - Choi Y
AD  - Department of Internal Medicine, Seoul National University Hospital, Seoul, South 
      Korea.
FAU - Kang, Minjoo
AU  - Kang M
AD  - National Evidence-based healthcare Collaborating Agency, Seoul, South Korea.
FAU - Shin, Minkyung
AU  - Shin M
AD  - National Evidence-based healthcare Collaborating Agency, Seoul, South Korea.
FAU - Koh, Youngil
AU  - Koh Y
AD  - Department of Internal Medicine, Seoul National University Hospital, Seoul, South 
      Korea. go01@snu.ac.kr.
AD  - National Evidence-based healthcare Collaborating Agency, Seoul, South Korea. 
      go01@snu.ac.kr.
FAU - Shin, Sangjin
AU  - Shin S
AD  - National Evidence-based healthcare Collaborating Agency, Seoul, South Korea. 
      jshin@neca.re.kr.
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20181119
PL  - Germany
TA  - Ann Hematol
JT  - Annals of hematology
JID - 9107334
SB  - IM
MH  - Adult
MH  - *Databases, Factual
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Hematologic Neoplasms/blood/*mortality/*therapy
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Republic of Korea/epidemiology
MH  - Retrospective Studies
MH  - Survival Rate
MH  - *Unrelated Donors
OTO - NOTNLM
OT  - Allogeneic stem cell transplantation
OT  - Alternative donor
OT  - HLA
OT  - International donor
EDAT- 2018/11/21 06:00
MHDA- 2019/01/29 06:00
CRDT- 2018/11/21 06:00
PHST- 2018/04/04 00:00 [received]
PHST- 2018/11/08 00:00 [accepted]
PHST- 2018/11/21 06:00 [pubmed]
PHST- 2019/01/29 06:00 [medline]
PHST- 2018/11/21 06:00 [entrez]
AID - 10.1007/s00277-018-3550-z [pii]
AID - 10.1007/s00277-018-3550-z [doi]
PST - ppublish
SO  - Ann Hematol. 2019 Feb;98(2):501-510. doi: 10.1007/s00277-018-3550-z. Epub 2018 
      Nov 19.