NDLI: Comparison of Outcomes after HLA-matched Sibling and Unrelated Donor Transplantation for Children with High-Risk Acute Lymphoblastic Leukemia

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Comparison of Outcomes after HLA-matched Sibling and Unrelated Donor Transplantation for Children with High-Risk Acute Lymphoblastic Leukemia

Content Provider	PubMed Central
Author	Thiel, Elizabeth L. Zhang, Mei-jie Davies, Stella M. Camitta, Bruce M. Logan, Brent Tiedemann, Karin Eapen, Mary
Copyright Year	2012
Abstract	We compared outcomes after 94 HLA-matched sibling, 168 unrelated donor bone marrow (BM) (n=81 matched and n=88 mismatched) and 86 cord blood transplantations in patients aged 1–15 years with acute lymphoblastic leukemia (ALL) in second complete remission (CR). All patients had their first bone marrow relapse within 3 years from diagnosis. Cox regression models were constructed to examine for differences in transplant-outcome by donor source. Risks of grade 2–4 acute GVHD and chronic GVHD, when compared to HLA-matched sibling transplants, were higher after matched unrelated donor BM (RR 2.42, p=0.001; RR 5.12, p<0.001, respectively), mismatched BM (RR 3.24, p<0.001; 5.19, p<0.001, respectively) and cord blood (RR 2.67, p<0.001; 2.54, p=0.024, respectively) transplants. Though non-relapse mortality was higher after transplantation of mismatched unrelated donor BM and cord blood, there were no differences in leukemia-free survival (LFS) between HLA-matched sibling and any of the unrelated donor transplantations. The 3-year probabilities of LFS were 50% after HLA-matched sibling and 44% after matched unrelated BM, 44% after mismatched unrelated BM and 43% after cord blood transplantation. Our observations support transplantation of BM or cord blood from a suitably matched unrelated donor or cord blood for patients without an HLA-matched sibling with ALL in second CR.
Related Links	http://dx.doi.org/10.1016/j.bbmt.2012.01.007
Ending Page	1210
Page Count	7
Starting Page	1204
File Format	PDF
ISSN	10838791
e-ISSN	15236536
Journal	Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Issue Number	8
Volume Number	18
Language	English
Publisher Date	2012-08-01
Access Restriction	Open
Subject Keyword	Transplantation Hematology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Hematology Transplantation

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