The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation

Olle Ringdén; Steven Z. Pavletic; Claudio Anasetti; A. John Barrett; Tao Wang; Dan Wang; Joseph H. Antin; Paolo Di Bartolomeo; Brian J. Bolwell; Christopher Bredeson; Mitchell S. Cairo; Robert P. Gale; Vikas Gupta; Theresa Hahn; Gregory A. Hale; Jorg Halter; Madan Jagasia; Mark R. Litzow; Franco Locatelli; David I. Marks; Philip L. McCarthy; Morton J. Cowan; Effie W. Petersdorf; James A. Russell; Gary J. Schiller; Harry Schouten; Stephen Spellman; Leo F. Verdonck; John R. Wingard; Mary M. Horowitz; Mukta Arora

doi:10.1182/blood-2008-07-163212

The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation

Olle Ringdén, Steven Z. Pavletic, Claudio Anasetti, A. John Barrett, Tao Wang, Dan Wang, Joseph H. Antin, Paolo Di Bartolomeo, Brian J. Bolwell, Christopher Bredeson, Mitchell S. Cairo, Robert P. Gale, Vikas Gupta, Theresa Hahn, Gregory A. Hale, Jorg Halter, Madan Jagasia, Mark R. Litzow, Franco Locatelli, David I. MarksPhilip L. McCarthy, Morton J. Cowan, Effie W. Petersdorf, James A. Russell, Gary J. Schiller, Harry Schouten, Stephen Spellman, Leo F. Verdonck, John R. Wingard, Mary M. Horowitz, Mukta Arora

Hematology

Research output: Contribution to journal › Article › peer-review

132 Scopus citations

Abstract

Do some patients benefit from an unrelated donor(URD) transplant because of a stronger graft-versus-leukemia(GVL) effect? We analyzed 4099 patients with acute myeloid leukemia(AML), acute lym-phoblastic leukemia(ALL), and chronic myeloid leukemia(CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation(HCT) from an URD(8/8 human leukocyte antigen [HLA]-matched, n = 941) or HLA-identical sibling donor(n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality(TRM; relative risk [RR], 2.76; P < .001) and relapse(RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival(LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant(RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same(ALL, CML) or worse(AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect.

Original language	English (US)
Pages (from-to)	3110-3118
Number of pages	9
Journal	Blood
Volume	113
Issue number	13
DOIs	https://doi.org/10.1182/blood-2008-07-163212
State	Published - Mar 26 2009

ASJC Scopus subject areas

Biochemistry
Immunology
Hematology
Cell Biology

Access to Document

10.1182/blood-2008-07-163212

Cite this

Ringdén, O., Pavletic, S. Z., Anasetti, C., Barrett, A. J., Wang, T., Wang, D., Antin, J. H., Di Bartolomeo, P., Bolwell, B. J., Bredeson, C., Cairo, M. S., Gale, R. P., Gupta, V., Hahn, T., Hale, G. A., Halter, J., Jagasia, M., Litzow, M. R., Locatelli, F., ... Arora, M. (2009). The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation. Blood, 113(13), 3110-3118. https://doi.org/10.1182/blood-2008-07-163212

Ringdén, O, Pavletic, SZ, Anasetti, C, Barrett, AJ, Wang, T, Wang, D, Antin, JH, Di Bartolomeo, P, Bolwell, BJ, Bredeson, C, Cairo, MS, Gale, RP, Gupta, V, Hahn, T, Hale, GA, Halter, J, Jagasia, M, Litzow, MR, Locatelli, F, Marks, DI, McCarthy, PL, Cowan, MJ, Petersdorf, EW, Russell, JA, Schiller, GJ, Schouten, H, Spellman, S, Verdonck, LF, Wingard, JR, Horowitz, MM & Arora, M 2009, 'The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation', Blood, vol. 113, no. 13, pp. 3110-3118. https://doi.org/10.1182/blood-2008-07-163212

@article{59d58048238b4c8d9882c3b73d3391a9,

title = "The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation",

abstract = "Do some patients benefit from an unrelated donor(URD) transplant because of a stronger graft-versus-leukemia(GVL) effect? We analyzed 4099 patients with acute myeloid leukemia(AML), acute lym-phoblastic leukemia(ALL), and chronic myeloid leukemia(CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation(HCT) from an URD(8/8 human leukocyte antigen [HLA]-matched, n = 941) or HLA-identical sibling donor(n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality(TRM; relative risk [RR], 2.76; P < .001) and relapse(RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival(LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant(RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same(ALL, CML) or worse(AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect.",

author = "Olle Ringd{\'e}n and Pavletic, {Steven Z.} and Claudio Anasetti and Barrett, {A. John} and Tao Wang and Dan Wang and Antin, {Joseph H.} and {Di Bartolomeo}, Paolo and Bolwell, {Brian J.} and Christopher Bredeson and Cairo, {Mitchell S.} and Gale, {Robert P.} and Vikas Gupta and Theresa Hahn and Hale, {Gregory A.} and Jorg Halter and Madan Jagasia and Litzow, {Mark R.} and Franco Locatelli and Marks, {David I.} and McCarthy, {Philip L.} and Cowan, {Morton J.} and Petersdorf, {Effie W.} and Russell, {James A.} and Schiller, {Gary J.} and Harry Schouten and Stephen Spellman and Verdonck, {Leo F.} and Wingard, {John R.} and Horowitz, {Mary M.} and Mukta Arora",

year = "2009",

month = mar,

day = "26",

doi = "10.1182/blood-2008-07-163212",

language = "English (US)",

volume = "113",

pages = "3110--3118",

journal = "Blood",

issn = "0006-4971",

publisher = "American Society of Hematology",

number = "13",

}

TY - JOUR

T1 - The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation

AU - Ringdén, Olle

AU - Pavletic, Steven Z.

AU - Anasetti, Claudio

AU - Barrett, A. John

AU - Wang, Tao

AU - Wang, Dan

AU - Antin, Joseph H.

AU - Di Bartolomeo, Paolo

AU - Bolwell, Brian J.

AU - Bredeson, Christopher

AU - Cairo, Mitchell S.

AU - Gale, Robert P.

AU - Gupta, Vikas

AU - Hahn, Theresa

AU - Hale, Gregory A.

AU - Halter, Jorg

AU - Jagasia, Madan

AU - Litzow, Mark R.

AU - Locatelli, Franco

AU - Marks, David I.

AU - McCarthy, Philip L.

AU - Cowan, Morton J.

AU - Petersdorf, Effie W.

AU - Russell, James A.

AU - Schiller, Gary J.

AU - Schouten, Harry

AU - Spellman, Stephen

AU - Verdonck, Leo F.

AU - Wingard, John R.

AU - Horowitz, Mary M.

AU - Arora, Mukta

PY - 2009/3/26

Y1 - 2009/3/26

N2 - Do some patients benefit from an unrelated donor(URD) transplant because of a stronger graft-versus-leukemia(GVL) effect? We analyzed 4099 patients with acute myeloid leukemia(AML), acute lym-phoblastic leukemia(ALL), and chronic myeloid leukemia(CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation(HCT) from an URD(8/8 human leukocyte antigen [HLA]-matched, n = 941) or HLA-identical sibling donor(n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality(TRM; relative risk [RR], 2.76; P < .001) and relapse(RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival(LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant(RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same(ALL, CML) or worse(AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect.

AB - Do some patients benefit from an unrelated donor(URD) transplant because of a stronger graft-versus-leukemia(GVL) effect? We analyzed 4099 patients with acute myeloid leukemia(AML), acute lym-phoblastic leukemia(ALL), and chronic myeloid leukemia(CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation(HCT) from an URD(8/8 human leukocyte antigen [HLA]-matched, n = 941) or HLA-identical sibling donor(n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality(TRM; relative risk [RR], 2.76; P < .001) and relapse(RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival(LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant(RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same(ALL, CML) or worse(AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect.

UR - http://www.scopus.com/inward/record.url?scp=63849276967&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=63849276967&partnerID=8YFLogxK

U2 - 10.1182/blood-2008-07-163212

DO - 10.1182/blood-2008-07-163212

M3 - Article

C2 - 19059878

AN - SCOPUS:63849276967

SN - 0006-4971

VL - 113

SP - 3110

EP - 3118

JO - Blood

JF - Blood

IS - 13

ER -

The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this