Determinants of survival after human leucocyte antigen-matched unrelated donor bone marrow transplantation in adults Academic Article Article uri icon

Overview

MeSH Major

  • Blood Banks
  • Blood Donors
  • Cord Blood Stem Cell Transplantation
  • Cryopreservation
  • Fetal Blood

abstract

  • Unrelated donor (URD) bone marrow transplantation (BMT) in adults can be associated with high non-relapse mortality (NRM). Therefore, factors determining survival in 136 human leucocyte antigen (HLA)-A, B, DRB1-matched adult BMT recipients were reviewed. Fifty-four per cent of patients had chronic myelogenous leukaemia (CML) and 36% had acute leukaemia or myelodysplasia. Graft-versus-host disease (GvHD) prophylaxis was either cyclosporin A (CSA)/methotrexate (64%) or T-cell depletion and CSA/corticosteroids (34%). The probability of donor engraftment by d 45 was 97% (95% CI: 94-100). Incidence of grades III-IV acute GvHD was 18% (95% CI: 12-24) at 100 d, and chronic GvHD was 42% (95% CI: 32-52) at 2 years. At 2 years, 14% (95% CI: 8-20) had relapsed. Multiple regression analysis showed that adverse risk factors for survival were non-CML diagnosis, age > 35 years, diagnosis to transplant time of > 18 months [chronic-phase CML (CML-CP) only]; and grades III-IV acute GvHD. Patients 35 years with early CML-CP was 55% (95% CI: 33-77), 40% (95% CI: 19-61) in advanced CML and 14% (95% CI:1-27) in non-CML. Future efforts should focus on improving the outcome for older BMT recipients, especially those with diagnoses other than CML.

publication date

  • July 27, 2002

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1046/j.1365-2141.2002.03676.x

PubMed ID

  • 12100132

Additional Document Info

start page

  • 101

end page

  • 7

volume

  • 118

number

  • 1