title: Matched unrelated or matched sibling donors result in comparable survival after allogeneic stem-cell transplantation in elderly patients with acute myeloid leukemia: a report from the cooperative German Transplant Study Group.
abstract: OBJECTIVE
  In patients with acute myeloid leukemia (AML), differential indications for matched sibling and unrelated hematopoietic stem-cell transplantation (HCT) are considered, and arbitrary age limits for HCT exist. We sought to determine whether donor type is a prognostic factor in elderly patients in the era of high-resolution DNA-based HLA typing.
  
  
  METHODS
  We performed univariate and multivariate analyses of event-free survival (EFS) and overall survival (OS) in patients older than 50 years with standard- or high-risk AML who had received an allogeneic HCT between 1995 and 2005. Available DNA from donors and recipients of unrelated HCT was retyped so that the HLA-A, -B, -C, and -DRB1 alleles could be characterized in detail. Unrelated donors (UDs) were classified as matched (8/8), possibly matched (matched, but incomplete information), partially matched (one mismatch), or poorly matched (two or more mismatches) according to the final typing results.
  
  
  RESULTS
  Data from 368 patients with a median age of 57 years (range, 50 to 73 years) were included. Multivariate Cox regression analysis revealed that patients' disease status at HCT (P < .001) and the cytogenetic risk (P < .001) highly significantly predicted EFS and OS. Compared with patients with matched sibling donors, the adjusted relative risk of EFS was 0.7 (95% CI, 0.4 to 1.1) for patients with matched UDs and 1.0 (95% CI, 0.7 to 1.6) for patients with partially matched UDs.
  
  
  CONCLUSIONS
  Donor type is not a major prognostic factor for HCT in elderly patients with standard- or high-risk AML.
authors.affiliation: Medizinische KIinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany. johannes.schetelig@uniklinikum-dresden.de
authors.forename: Johannes
authors.initials: J
authors.lastname: Schetelig
authors.forename: Martin
authors.initials: M
authors.lastname: Bornhäuser
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmid
authors.forename: Bernd
authors.initials: B
authors.lastname: Hertenstein
authors.forename: Rainer
authors.initials: R
authors.lastname: Schwerdtfeger
authors.forename: Hans
authors.initials: H
authors.lastname: Martin
authors.forename: Matthias
authors.initials: M
authors.lastname: Stelljes
authors.forename: Ute
authors.initials: U
authors.lastname: Hegenbart
authors.forename: Kerstin
authors.initials: K
authors.lastname: Schäfer-Eckart
authors.forename: Monika
authors.initials: M
authors.lastname: Füssel
authors.forename: Barbel
authors.initials: B
authors.lastname: Wiedemann
authors.forename: Christian
authors.initials: C
authors.lastname: Thiede
authors.forename: Joachim
authors.initials: J
authors.lastname: Kienast
authors.forename: Herrad
authors.initials: H
authors.lastname: Baurmann
authors.forename: Arnold
authors.initials: A
authors.lastname: Ganser
authors.forename: Hans Jochem
authors.initials: HJ
authors.lastname: Kolb
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger