Impact of donor age on outcome after allogeneic hematopoietic cell transplantation.
Impact of donor age on outcome after allogeneic hematopoietic cell transplantation.
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DOI：
10.1016/j.bbmt.2014.09.021
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发表时间：
2015-01
影响因子：
4.3
通讯作者：
Storb, Rainer
中科院分区：
文献类型：
--
作者：
Rezvani, Andrew R.;Storer, Barry E.;Guthrie, Katherine A.;Schoch, H. Gary;Maloney, David G.;Sandmaier, Brenda M.;Storb, Rainer
关键词：
由于老年患者有资格接受同种异体造血细胞移植（HCT），越来越多的人建议年长的兄弟姐妹作为捐献者。我们研究了供体年龄对造血移植速度和供体嵌合、急性和慢性移植物抗宿主病 (GVHD) 以及非复发死亡率 (NRM) 的影响，研究对象为 1,174 名连续接受清髓性 HCT 的患者和 367 名接受非清髓性 HCT 的患者，这些患者来自 HLA 匹配的相关或无关供体。 G-CSF 动员的外周血单核细胞 (G-PBMC) 同种异体移植物。在接受清髓性和非清髓性预处理的患者中，对于来自 <60 岁供体（较年轻；n=1,416）的移植物，持续植入率分别为 97% 和 98%；对于来自 ≥60 岁供体（较老；n=125）的移植物，持续植入率分别为 98% 和 100%。除了年龄较大供体的清髓性患者的中性粒细胞恢复平均延迟 1.3 天外，中性粒细胞和血小板恢复速度以及供体嵌合状态没有显着差异（P = 0.04）。 CD34+细胞剂量对植入速度具有独立影响。 HCT 后，老化的干细胞并未导致供体来源的克隆性疾病的风险增加。与年龄较大的兄弟姐妹捐赠者相比，清髓性和非清髓性受者的 II-IV 级急性 GVHD 明显低于年轻无亲缘关系捐赠者的移植物受者。老年供者的受者的 III-IV 级急性 GVHD、慢性 GVHD 和 NRM 的发生率与年轻供者的受者没有显着差异。总之，与年轻供体的移植物相比，≥60 岁供体的移植物不会对同种异体 HCT 的结果产生不利影响。
As older patients are eligible for allogeneic hematopoietic cell transplantation (HCT), older siblings are increasingly proposed as donors. We studied the impact of donor age on the tempo of hematopoietic engraftment and donor chimerism, acute and chronic graft-vs.-host disease (GVHD), and non-relapse mortality (NRM) among 1,174 consecutive patients undergoing myeloablative and 367 patients undergoing non-myeloablative HCT from HLA-matched related or unrelated donors with G-CSF-mobilized peripheral blood mononuclear cell (G-PBMC) allografts. Sustained engraftment rates were 97% and 98% in patients undergoing myeloablative and non-myeloablative conditioning, respectively, for grafts from donors <60 years old (younger; n=1,416) and 98% and 100%, respectively, for those from donors ≥60 years old (older; n=125). No significant differences were seen in the tempo of neutrophil and platelet recoveries and donor chimerism except for an average 1.3-day delay in neutrophil recovery among myeloablative patients with older donors (P = 0.04). CD34+ cell dose had an independent effect on the tempo of engraftment. Aged stem cells did not convey an increased risk of donor-derived clonal disorders after HCT. Myeloablative and non-myeloablative recipients with older sibling donors had significantly less grade II–IV acute GVHD than recipients with grafts from younger unrelated donors. Rates of grade III–IV acute GVHD, chronic GVHD, and NRM for recipients with older donors were not significantly different from recipients with younger donors. In conclusion, grafts from donors ≥60 years old do not adversely affect outcomes of allogeneic HCT compared to grafts from younger donors.
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影响因子：
20.3
作者：
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通讯作者：
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影响因子：
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120.7
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通讯作者：
Storb, Rainer