title: Allogeneic marrow stem-cell transplantation from human leukocyte antigen-identical siblings versus human leukocyte antigen-allelic-matched unrelated donors (10/10) in patients with standard-risk hematologic malignancy: a prospective study from the French Society of Bone Marrow Transplantation and Cell Therapy.
abstract: OBJECTIVE
  To investigate the influence of donor type (human leukocyte antigen [HLA] -identical sibling donor versus HLA-A-, HLA-B-, HLA-Cw-, HLA-DRB1-, and HLA-DQB1-identical unrelated donors, or so-called 10/10) on the outcome of patients who underwent allogeneic stem-cell transplantation (alloSCT), adjusting for other prognostic factors, in patients with standard-risk hematologic malignancy.
  
  
  METHODS
  Between March 2000 and January 2003, we prospectively investigated the outcome of 236 consecutive patients with standard-risk malignancy from 12 French centers. Fifty-five patients underwent alloSCT from an unrelated HLA-identical donor at the allelic level, whereas 181 patients received an alloSCT from an HLA-identical sibling. Diagnoses included acute leukemia (n = 175), chronic myeloid leukemia (n = 43), and myelodysplastic syndrome (MDS; n = 18). All patients received unmodified marrow graft following myeloablative conditioning with cyclophosphamide and total-body irradiation. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and short-course methotrexate in all patients.
  
  
  RESULTS
  In multivariable analysis, overall survival and transplantation-related mortality were adversely influenced by recipient cytomegalovirus (CMV) -positive serology, age of donor older than 37 years, and the occurrence of acute grade > or = II GVHD. Event-free survival rates were lower for patients with recipient CMV-positive serology. Acute grades II to IV GVHD rates were higher for patients with chronic myeloid leukemia (CML). No factor was found to influence either relapse or acute grades III to IV GVHD. The effect of donor type was nonsignificant for all criteria.
  
  
  CONCLUSIONS
  In patients with standard-risk malignancy, transplantation from unrelated HLA-allellically matched donors led to outcomes similar to those from HLA-identical sibling donors.
authors.affiliation: Agence de la biomédecine, St Denis, France.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub-Agha
authors.forename: Florence
authors.initials: F
authors.lastname: Mesnil
authors.forename: Mathieu
authors.initials: M
authors.lastname: Kuentz
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Boiron
authors.forename: Norbert
authors.initials: N
authors.lastname: Ifrah
authors.forename: Noel
authors.initials: N
authors.lastname: Milpied
authors.forename: Sami
authors.initials: S
authors.lastname: Chehata
authors.forename: Helene
authors.initials: H
authors.lastname: Esperou
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Vernant
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.forename: Agnes
authors.initials: A
authors.lastname: Buzyn
authors.forename: Nicole
authors.initials: N
authors.lastname: Gratecos
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Cahn
authors.forename: Jean Henri
authors.initials: JH
authors.lastname: Bourhis
authors.forename: Zina
authors.initials: Z
authors.lastname: Chir
authors.forename: Colette
authors.initials: C
authors.lastname: Raffoux
authors.forename: Gerard
authors.initials: G
authors.lastname: Socié
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Golmard
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Jouet
mesh_terms: D000328:Adult; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D011446:Prospective Studies; D035781:Siblings; D033581:Stem Cell Transplantation; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome