Comparative analysis of outcomes of allogeneic peripheral blood stem cell transplantation from related and unrelated donors.
This study compared the results of allogeneic peripheral blood stem cell transplantation (PBSCT) from unrelated and related donors, and involved 235 consecutive patients from ten centers between Jan 2004 and Dec 2008. Among these patients, 160 (68.1%) received a human leukocyte antigen-matched related PBSCT and 75 (31.9%), a matched unrelated PBSCT. The cumulative incidence of acute graft-versus-host disease (GVHD) was 43.9% for the related PBSCT and 59.3% for the unrelated PBSCT. Although the cumulative incidence of chronic GVHD was no different between the related (54.2%) and unrelated (64.9%) PBSCT, the cumulative incidence of extensive chronic GVHD was higher among the unrelated PBSCT (34.9%) than among the related PBSCT (17.0%). The overall survival rate at 4 years was 58.2% versus 49.1%, and the cumulative incidence of relapse was 28.4% versus 25.0% for the related and unrelated PBSCT, respectively. Among the factors examined, unrelated PBSCT, the CD34-positive cell count, and cytomegalovirus infection were all related with a higher incidence of extensive chronic GVHD. However, in a multivariate analysis, only unrelated PBSCT was identified as a risk factor for the development of extensive chronic GVHD (hazard ratio = 2.012; P value, 0.048). In conclusion, the survival and relapse incidence were not significantly different between the related and unrelated PBSCT.
Kang
Byung Woog
BW
Department of Hematology/Oncology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Jung-Gu, Daegu, South Korea.
Moon
Joon Ho
JH
Chae
Yee Soo
YS
Kim
Jong Gwang
JG
Jung
Joo Seop
JS
Cho
Goon-Jae
GJ
Jo
Deog-Yeon
DY
Kim
Yeo Kyeoung
YK
Kim
Hyeoung Joon
HJ
Ryoo
Hun-Mo
HM
Eom
Hyeon Seok
HS
Lee
Sang Min
SM
Joo
Young-Don
YD
Won
Jong-Ho
JH
Park
Moo Rim
MR
Kim
Min Kyung
MK
Hyun
Myung Soo
MS
Sohn
Sang Kyun
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000517:prevention & control; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
D006680:HLA Antigens