Outcomes after matched unrelated donor versus identical sibling hematopoietic cell transplantation in adults with acute myelogenous leukemia
Outcomes after matched unrelated donor versus identical sibling hematopoietic cell transplantation in adults with acute myelogenous leukemia
复制标题
DOI：
10.1182/blood-2011-09-381699
复制
发表时间：
2012-04-26
期刊：
影响因子：
20.3
通讯作者：
Schriber, Jeff
中科院分区：
文献类型：
--
作者：
Saber, Wael;Opie, Shaun;Schriber, Jeff
在有造血细胞移植(HCT)指征的患者中，约有三分之一的患者有与其相匹配的亲属供者(MRD)。对于其余的患者，匹配的无血缘关系的供者(MUD)是一种选择。以前比较MRD和MUD HCT的研究提供了相互矛盾的结果，而MRD和MUD移植的相对疗效是一个积极研究的领域。为了解决这个问题，我们分析了2002-2006年间接受异基因HCT的2223名成人急性髓系白血病患者的结果(MRD，n=624；8/8个HLA基因座匹配MUD，n=1193；7/8 MUD，n=406)。接受MRD HCT的患者100天内B-D级急性移植物抗宿主病的累积发生率显著低于8/8 MUD和7/8 MUD HCT患者(分别为33%、51%和53%；P<；001)。在多因素分析中，8/8接受MUD HCT的患者与接受MRD HCT的患者相比存活率相似(相对危险度[RR]，1.03；P=0.62)。7/8接受MUD HCT的患者早期死亡率高于MRD HCT患者(RR，1.40；P<；.001)，但在HCT后6个月以上，两者的存活率相似(RR，0.88；P=.30)。这些结果表明，来自MUD和MRD供者的移植对急性髓系白血病患者的生存时间相似。(血。2012年；119(17)：3908-3916)
Approximately one-third of patients with an indication for hematopoietic cell transplantation (HCT) have an HLA-matched related donor (MRD) available to them. For the remaining patients, a matched unrelated donor (MUD) is an alternative. Prior studies comparing MRD and MUD HCT provide conflicting results, and the relative efficacy of MRD and MUD transplantation is an area of active investigation. To address this issue, we analyzed outcomes of 2223 adult acute myelogenous leukemia patients who underwent allogeneic HCT between 2002 and 2006 (MRD, n = 624; 8/8 HLA locus matched MUD, n = 1193; 7/8 MUD, n = 406). The 100-day cumulative incidence of grades B-D acute GVHD was significantly lower in MRD HCT recipients than in 8/8 MUD and 7/8 MUD HCT recipients (33%, 51%, and 53%, respectively; P < 001). In multivariate analysis, 8/8 MUD HCT recipients had a similar survival rate compared with MRD HCT recipients (relative risk [RR], 1.03; P = .62). 7/8 MUD HCT recipients had higher early mortality than MRD HCT recipients (RR, 1.40; P < .001), but beyond 6 months after HCT, their survival rates were similar (RR, 0.88; P = .30). These results suggest that transplantation from MUD and MRD donors results in similar survival times for patients with acute myelogenous leukemia. (Blood. 2012;119(17):3908-3916)