Stem cell transplantation from identical twins in patients with myelodysplastic syndromes
Stem cell transplantation from identical twins in patients with myelodysplastic syndromes
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DOI：
10.1038/sj.bmt.1704701
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发表时间：
2005-01-01
影响因子：
4.8
通讯作者：
de Witte, T
中科院分区：
文献类型：
--
作者：
Kröger, N;Brand, R;de Witte, T
在一项多中心回顾性EBMT数据库研究中，我们分析了影响38例MDS/sAML患者结果的因素，这些患者移植了来自同基因双胞胎的干细胞，并将其与1444例移植自HLA相同同胞的患者进行了比较。双胞胎组的白细胞和血小板植入的中位时间更快：分别为14 vs 17（P=0.02）和16 vs 26天（P=0.09）。5年治疗相关死亡率（TRM）的累积发生率在同胞组高于双胞胎组（38 vs 27%; P=0.05）。兄弟姐妹和双胞胎的5年累积复发率分别为32%（95%CI：29-35%）和39%（95%CI：26-60%; P=0.6）。在双胞胎组中观察到5年无病生存率和总生存率更好的趋势：分别为34%（95%CI：14-54%）vs 28%（95%CI：25-31%; P=0.2）和36%（95%CI：15-57%）vs 32%（95%CI：29-35%; P=0.09）。在多变量分析中，来自同卵双胞胎的干细胞移植具有较低的TRM：HR：0.4（95%CI：0.2-0.9; P=0.03）。两组的复发率相似，HR为1.2（95% CI：0.07-2.1; P=0.5），双胞胎的生存率更高：HR为0.6（95% CI：0.4-1.0; P=0.07）。我们的结论是，双胞胎移植在MDS/sAML与类似的复发风险，较低的TRM和更好的总生存率的趋势相比，HLA相同的兄弟姐妹移植。
In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-identical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P=0.02) and 16 vs 26 days (P=0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27%; P=0.05). The 5 year cumulative incidence of relapse was 32% (95% CI: 29-35%) for the siblings and 39% (95% CI: 26-60%; P=0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34% (95% CI: 14-54%) vs 28% (95% CI: 25-31%; P=0.2) and 36% (95% CI: 15-57%) vs 32% (95% CI: 29-35%; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95% CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95% CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95% CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.