title: Matched unrelated or matched sibling donors result in comparable outcomes after non-myeloablative HSCT in patients with AML or MDS.
abstract: The impact of allelic HLA matching in patients with AML and myelodysplastic syndrome (MDS) who receive allogeneic PBSC after a reduced-intensity conditioning (RIC) regimen is unclear. From January 2000 to December 2010, 108 consecutive patients with AML (n=63) and MDS (n=45) received PBSC after RIC in our center, either from siblings (n=70) or from matched unrelated donors (MUD; 10/10 high resolution, n=38). Conditioning regimen was fludarabine based in 95% of patients and GvHD prophylaxis was mostly cyclosporine plus mycophenolate. Patient characteristics were similar between sibling and MUD for age (median 57 years), gender and disease distribution. Conditioning regimen (more anti-thymocyte globulin (ATG) in MUD), donor age (younger for MUD) and number of CD34+ cells infused (higher in MUD) were different. The median follow-up was 36 months (range 2-72). Engraftment, GvHD, TRM, relapse rate and OS at 3 years were comparable between sibling and MUD. After adjustment for age, cytogenetic risk, ATG and number of CD34+ cells infused, donor type still did not influence OS. In patients with AML or MDS, HSCT from MUD using PBSC after a RIC regimen led to similar outcomes than from Siblings.
authors.affiliation: Service d'Hématologie Greffe, Hôpital Saint Louis, AP-HP, Université Paris Diderot, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Robin
authors.forename: R
authors.initials: R
authors.lastname: Porcher
authors.forename: L
authors.initials: L
authors.lastname: Adès
authors.forename: N
authors.initials: N
authors.lastname: Boissel
authors.forename: E
authors.initials: E
authors.lastname: Raffoux
authors.forename: A
authors.initials: A
authors.lastname: Xhaard
authors.forename: J
authors.initials: J
authors.lastname: Larghero
authors.forename: C
authors.initials: C
authors.lastname: Gardin
authors.forename: C
authors.initials: C
authors.lastname: Himberlin
authors.forename: A
authors.initials: A
authors.lastname: Delmer
authors.forename: P
authors.initials: P
authors.lastname: Fenaux
authors.forename: H
authors.initials: H
authors.lastname: Dombret
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.forename: R
authors.initials: R
authors.lastname: Peffault de Latour
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D012189:Retrospective Studies; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D061349:Unrelated Donors; D055815:Young Adult