Comparable post-relapse outcomes between haploidentical and matched related donor allogeneic stem cell transplantation
We investigated the impact of donor type on post-relapse survival (PRS) in 85 patients with hematological relapse after their first allogeneic hematological stem cell transplantation (allo-HSCT) for hematological malignancy. The median follow-up was 64 months among survivors. Both 3-year overall sur...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2017-03, Vol.52 (3), p.409-414 |
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| creator | Ma, Y-R Xu, L-P Zhang, X-H Yan, C-H Wang, Y Wang, F-R Wang, J-Z Chen, Y Han, W Chen, Y-H Chen, H Liu, K-Y Huang, X-J |
| description | We investigated the impact of donor type on post-relapse survival (PRS) in 85 patients with hematological relapse after their first allogeneic hematological stem cell transplantation (allo-HSCT) for hematological malignancy. The median follow-up was 64 months among survivors. Both 3-year overall survival and 3-year PRS were similar in haploidentical donor (HID) and matched sibling donor (MRD) transplantation (13.0%±4.7% vs 19.4%±7.1%,
P
=0.913 and 7.7±3.9% vs 9.7±5.3%,
P
= 0.667). Higher rates of post-relapse grade II–IV and III–IV acute GvHD (aGvHD) were observed in HID transplantation patients. A higher cumulative incidence of post-relapse extensive chronic GvHD was also observed for HID transplantation patients. Multivariate analyses confirmed that treatment including donor lymphocyte infusion (DLI), late relapse >1 year, and in first CR at transplantation were associated with superior PRS (
P
=0.012, hazard ratio (HR)=0.527 (0.320−0.866));
P
=0.033, HR=0.534 (0.300−0.952) and
P
=0.046, HR=0.630 (0.400−0.992). The data suggest that post-relapse outcomes are comparable in HID and MRD transplantation, and that DLI is safe for relapsed patients after haploidentical transplantation. |
| doi_str_mv | 10.1038/bmt.2016.283 |
| format | Article |
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P
=0.913 and 7.7±3.9% vs 9.7±5.3%,
P
= 0.667). Higher rates of post-relapse grade II–IV and III–IV acute GvHD (aGvHD) were observed in HID transplantation patients. A higher cumulative incidence of post-relapse extensive chronic GvHD was also observed for HID transplantation patients. Multivariate analyses confirmed that treatment including donor lymphocyte infusion (DLI), late relapse >1 year, and in first CR at transplantation were associated with superior PRS (
P
=0.012, hazard ratio (HR)=0.527 (0.320−0.866));
P
=0.033, HR=0.534 (0.300−0.952) and
P
=0.046, HR=0.630 (0.400−0.992). The data suggest that post-relapse outcomes are comparable in HID and MRD transplantation, and that DLI is safe for relapsed patients after haploidentical transplantation.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/bmt.2016.283</identifier><identifier>PMID: 27797365</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/699/1541/1990 ; 692/700/565/2319 ; Adolescent ; Adult ; Allografts ; Bone marrow ; Cell Biology ; Child ; Child, Preschool ; Comparative analysis ; Disease-Free Survival ; Female ; Follow-Up Studies ; Graft vs Host Disease - mortality ; Graft vs Host Disease - therapy ; Graft-versus-host reaction ; Hematologic Neoplasms - mortality ; Hematologic Neoplasms - therapy ; Hematology ; Hematopoietic Stem Cell Transplantation ; Humans ; Internal Medicine ; Lymphocytes ; Male ; Malignancy ; Medicine ; Medicine & Public Health ; Middle Aged ; original-article ; Patient outcomes ; Patients ; Public Health ; Recurrence (Disease) ; Siblings ; Stem cell transplantation ; Stem Cells ; Survival ; Survival Rate ; Transplantation ; Unrelated Donors</subject><ispartof>Bone marrow transplantation (Basingstoke), 2017-03, Vol.52 (3), p.409-414</ispartof><rights>Macmillan Publishers Limited, part of Springer Nature. 2017</rights><rights>COPYRIGHT 2017 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Mar 2017</rights><rights>Macmillan Publishers Limited, part of Springer Nature. 2017.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c554t-61d8b95eed2ac5a8d75c36abfa8006bd80c6c5998da4762adfdfe26c85355103</citedby><cites>FETCH-LOGICAL-c554t-61d8b95eed2ac5a8d75c36abfa8006bd80c6c5998da4762adfdfe26c85355103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/bmt.2016.283$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/bmt.2016.283$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27797365$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ma, Y-R</creatorcontrib><creatorcontrib>Xu, L-P</creatorcontrib><creatorcontrib>Zhang, X-H</creatorcontrib><creatorcontrib>Yan, C-H</creatorcontrib><creatorcontrib>Wang, Y</creatorcontrib><creatorcontrib>Wang, F-R</creatorcontrib><creatorcontrib>Wang, J-Z</creatorcontrib><creatorcontrib>Chen, Y</creatorcontrib><creatorcontrib>Han, W</creatorcontrib><creatorcontrib>Chen, Y-H</creatorcontrib><creatorcontrib>Chen, H</creatorcontrib><creatorcontrib>Liu, K-Y</creatorcontrib><creatorcontrib>Huang, X-J</creatorcontrib><title>Comparable post-relapse outcomes between haploidentical and matched related donor allogeneic stem cell transplantation</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><addtitle>Bone Marrow Transplant</addtitle><description>We investigated the impact of donor type on post-relapse survival (PRS) in 85 patients with hematological relapse after their first allogeneic hematological stem cell transplantation (allo-HSCT) for hematological malignancy. The median follow-up was 64 months among survivors. Both 3-year overall survival and 3-year PRS were similar in haploidentical donor (HID) and matched sibling donor (MRD) transplantation (13.0%±4.7% vs 19.4%±7.1%,
P
=0.913 and 7.7±3.9% vs 9.7±5.3%,
P
= 0.667). Higher rates of post-relapse grade II–IV and III–IV acute GvHD (aGvHD) were observed in HID transplantation patients. A higher cumulative incidence of post-relapse extensive chronic GvHD was also observed for HID transplantation patients. Multivariate analyses confirmed that treatment including donor lymphocyte infusion (DLI), late relapse >1 year, and in first CR at transplantation were associated with superior PRS (
P
=0.012, hazard ratio (HR)=0.527 (0.320−0.866));
P
=0.033, HR=0.534 (0.300−0.952) and
P
=0.046, HR=0.630 (0.400−0.992). The data suggest that post-relapse outcomes are comparable in HID and MRD transplantation, and that DLI is safe for relapsed patients after haploidentical transplantation.</description><subject>692/699/1541/1990</subject><subject>692/700/565/2319</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Allografts</subject><subject>Bone marrow</subject><subject>Cell Biology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Comparative analysis</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft vs Host Disease - mortality</subject><subject>Graft vs Host Disease - therapy</subject><subject>Graft-versus-host reaction</subject><subject>Hematologic Neoplasms - mortality</subject><subject>Hematologic Neoplasms - therapy</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Lymphocytes</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>original-article</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Public Health</subject><subject>Recurrence (Disease)</subject><subject>Siblings</subject><subject>Stem cell transplantation</subject><subject>Stem Cells</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Transplantation</subject><subject>Unrelated Donors</subject><issn>0268-3369</issn><issn>1476-5365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNks2LFDEQxRtR3HH15lkCgniwx3x00slxGfyCBS97D-mkeqaXdNImGRf_e9PMqruyiORQkPyqKu_xmuYlwVuCmXw_zGVLMRFbKtmjZkO6XrScCf642WAqZMuYUGfNs5yvMSZdh_nT5oz2veors2m-7-K8mGQGD2iJubQJvFkyoHgsNs6Q0QDlBiCgg1l8nByEMlnjkQkOzabYAzi09pRaXQwxIeN93EOAyaJcYEYWvEclmZAXb0IxZYrhefNkND7Di9t63lx9_HC1-9xefv30ZXdx2VrOu9IK4uSgOICjxnIjXc8tE2YYjcRYDE5iKyxXSjpTZVPjRjcCFVZyxnl157x5exq7pPjtCLnoecrrf0yAeMyayL6XRHWk_w-UdUoJ1dGKvv4LvY7HFKoOTUVHqWCUkn9RdS1VmDDV_6H2xoOewhirU3ZdrS86ybiikqpKbR-g6nEwTzYGGKd6f6_hzZ2GAxhfDjn64-p9vg--O4E2xZwTjHpJ02zSD02wXvOla770mi9d81XxV7eijsMM7jf8K1AVaE9Ark9hD-mO6ocG_gTay9kX</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Ma, Y-R</creator><creator>Xu, L-P</creator><creator>Zhang, X-H</creator><creator>Yan, C-H</creator><creator>Wang, Y</creator><creator>Wang, F-R</creator><creator>Wang, J-Z</creator><creator>Chen, Y</creator><creator>Han, W</creator><creator>Chen, Y-H</creator><creator>Chen, H</creator><creator>Liu, K-Y</creator><creator>Huang, X-J</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Comparable post-relapse outcomes between haploidentical and matched related donor allogeneic stem cell transplantation</title><author>Ma, Y-R ; Xu, L-P ; Zhang, X-H ; Yan, C-H ; Wang, Y ; Wang, F-R ; Wang, J-Z ; Chen, Y ; Han, W ; Chen, Y-H ; Chen, H ; Liu, K-Y ; Huang, X-J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c554t-61d8b95eed2ac5a8d75c36abfa8006bd80c6c5998da4762adfdfe26c85355103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>692/699/1541/1990</topic><topic>692/700/565/2319</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Allografts</topic><topic>Bone marrow</topic><topic>Cell Biology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Comparative analysis</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft vs Host Disease - mortality</topic><topic>Graft vs Host Disease - therapy</topic><topic>Graft-versus-host reaction</topic><topic>Hematologic Neoplasms - mortality</topic><topic>Hematologic Neoplasms - therapy</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Lymphocytes</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>original-article</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Public Health</topic><topic>Recurrence (Disease)</topic><topic>Siblings</topic><topic>Stem cell transplantation</topic><topic>Stem Cells</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Transplantation</topic><topic>Unrelated Donors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ma, Y-R</creatorcontrib><creatorcontrib>Xu, L-P</creatorcontrib><creatorcontrib>Zhang, X-H</creatorcontrib><creatorcontrib>Yan, C-H</creatorcontrib><creatorcontrib>Wang, Y</creatorcontrib><creatorcontrib>Wang, F-R</creatorcontrib><creatorcontrib>Wang, J-Z</creatorcontrib><creatorcontrib>Chen, Y</creatorcontrib><creatorcontrib>Han, W</creatorcontrib><creatorcontrib>Chen, Y-H</creatorcontrib><creatorcontrib>Chen, H</creatorcontrib><creatorcontrib>Liu, K-Y</creatorcontrib><creatorcontrib>Huang, X-J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Bone marrow transplantation (Basingstoke)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ma, Y-R</au><au>Xu, L-P</au><au>Zhang, X-H</au><au>Yan, C-H</au><au>Wang, Y</au><au>Wang, F-R</au><au>Wang, J-Z</au><au>Chen, Y</au><au>Han, W</au><au>Chen, Y-H</au><au>Chen, H</au><au>Liu, K-Y</au><au>Huang, X-J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparable post-relapse outcomes between haploidentical and matched related donor allogeneic stem cell transplantation</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><stitle>Bone Marrow Transplant</stitle><addtitle>Bone Marrow Transplant</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>52</volume><issue>3</issue><spage>409</spage><epage>414</epage><pages>409-414</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><abstract>We investigated the impact of donor type on post-relapse survival (PRS) in 85 patients with hematological relapse after their first allogeneic hematological stem cell transplantation (allo-HSCT) for hematological malignancy. The median follow-up was 64 months among survivors. Both 3-year overall survival and 3-year PRS were similar in haploidentical donor (HID) and matched sibling donor (MRD) transplantation (13.0%±4.7% vs 19.4%±7.1%,
P
=0.913 and 7.7±3.9% vs 9.7±5.3%,
P
= 0.667). Higher rates of post-relapse grade II–IV and III–IV acute GvHD (aGvHD) were observed in HID transplantation patients. A higher cumulative incidence of post-relapse extensive chronic GvHD was also observed for HID transplantation patients. Multivariate analyses confirmed that treatment including donor lymphocyte infusion (DLI), late relapse >1 year, and in first CR at transplantation were associated with superior PRS (
P
=0.012, hazard ratio (HR)=0.527 (0.320−0.866));
P
=0.033, HR=0.534 (0.300−0.952) and
P
=0.046, HR=0.630 (0.400−0.992). The data suggest that post-relapse outcomes are comparable in HID and MRD transplantation, and that DLI is safe for relapsed patients after haploidentical transplantation.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>27797365</pmid><doi>10.1038/bmt.2016.283</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Bone marrow transplantation (Basingstoke), 2017-03, Vol.52 (3), p.409-414 |
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| language | eng |
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| source | MEDLINE; Nature; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | 692/699/1541/1990 692/700/565/2319 Adolescent Adult Allografts Bone marrow Cell Biology Child Child, Preschool Comparative analysis Disease-Free Survival Female Follow-Up Studies Graft vs Host Disease - mortality Graft vs Host Disease - therapy Graft-versus-host reaction Hematologic Neoplasms - mortality Hematologic Neoplasms - therapy Hematology Hematopoietic Stem Cell Transplantation Humans Internal Medicine Lymphocytes Male Malignancy Medicine Medicine & Public Health Middle Aged original-article Patient outcomes Patients Public Health Recurrence (Disease) Siblings Stem cell transplantation Stem Cells Survival Survival Rate Transplantation Unrelated Donors |
| title | Comparable post-relapse outcomes between haploidentical and matched related donor allogeneic stem cell transplantation |
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