title: Long-term outcomes of HLA-matched sibling compared with mismatched related and unrelated donor hematopoietic stem cell transplantation for chronic phase chronic myelogenous leukemia: a single institution experience in China.
abstract: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative therapy for chronic myelogenous leukemia (CML). In this study, the long-term outcomes of HLA-matched sibling donor (MSD) with mismatched related donor (MRD) and unrelated donor (URD) transplantation for CML in the first chronic phase (CML-CP1) using different graft vs. host disease (GVHD) prophylaxis regimens according to donor source and the degree of HLA matching were compared. The data of 91 patients with CML-CP1 were analyzed with respect to GVHD, overall survival (OS), and transplant-related mortality (TRM). The incidence of grade II-IV acute GVHD was 25.5% in the MSD and 40.5% in the MRD/URD group (P = 0.133). The 1-year cumulative incidence of chronic GVHD was not different between the MSD and the MRD/URD groups, while extensive chronic GVHD was different between the two groups (31.9% vs. 10.8%, P = 0.023). The 5-year cumulative relapse rate was not different between the MSD and the MRD/URD groups, while TRM was different between the two groups (6.6% vs. 26.3%, P = 0.010). The 5-year cumulative OS was 90.9%, 71.5%, and 85.4% in the MSD, the MRD/URD, and the HLA allele-matched URD transplantation, respectively (MSD vs. MRD/URD, P = 0.013; MSD vs. HLA allele-matched URD, P = 0.437). In conclusion, survival in HLA allele-matched URD is equivalent to MSD, but in MRD and mismatched URD is inferior to MSD in patients with CML-CP1 undergoing allo-HSCT using different GVHD prophylaxis regimens according to donor source and degree of HLA matching. Patients undergoing MRD/URD transplantation have an equal quality of life as patients undergoing MSD transplantation.
authors.affiliation: Department Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China. liuqifa@fimmu.com
authors.forename: Qi-fa
authors.initials: QF
authors.lastname: Liu
authors.forename: Xiao-jun
authors.initials: XJ
authors.lastname: Xu
authors.forename: Yin-kui
authors.initials: YK
authors.lastname: Chen
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhi-ping
authors.initials: ZP
authors.lastname: Fan
authors.forename: Dan
authors.initials: D
authors.lastname: Xu
authors.forename: Qian-li
authors.initials: QL
authors.lastname: Jiang
authors.forename: Yong-qiang
authors.initials: YQ
authors.lastname: Wei
authors.forename: Fen
authors.initials: F
authors.lastname: Huang
authors.forename: Ru
authors.initials: R
authors.lastname: Feng
authors.forename: Xiao-li
authors.initials: XL
authors.lastname: Liu
authors.forename: Bing
authors.initials: B
authors.lastname: Xu
authors.forename: Fan-yi
authors.initials: FY
authors.lastname: Meng
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control; D006680:HLA Antigens / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D015466:Leukemia, Myeloid, Chronic-Phase / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D035781:Siblings; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006680:HLA Antigens