title: Impact of donor source on hematopoietic cell transplantation outcomes for patients with myelodysplastic syndromes (MDS).
abstract: Allogeneic hematopoietic cell transplantation (HCT) from human leukocyte antigen (HLA) matched related donor (MRD) and matched unrelated donors (MUD) produces similar survival for patients with acute myelogenous leukemia. Whether these results can be extended to patients with myelodysplastic syndromes (MDS) is unknown. Therefore, analysis of post-HCT outcomes for MDS was performed. Outcomes of 701 adult MDS patients who underwent HCT between 2002 and 2006 were analyzed (MRD [n = 176], 8 of 8 HLA-A, -B, -C, -DRB1 allele matched MUD [n = 413], 7 of 8 MUD [ n = 112]). Median age was 53 years (range, 22-78 years). In multivariate analyses, MRD HCT recipients had similar disease free survival (DFS) and survival rates compared with 8 of 8 MUD HCT recipients (relative risk [RR] 1.13 [95% confidence interval (CI) 0.91-1.42] and 1.24 [95% CI 0.98-1.56], respectively), and both MRD and 8 of 8 MUD had superior DFS (RR 1.47 [95% CI 1.10-1.96] and 1.29 [95% CI 1.00-1.66], respectively) and survival (RR 1.62 [95% CI 1.21-2.17] and 1.30 [95% CI 1.01-1.68], respectively) compared with 7 of 8 MUD HCT recipients. In patients with MDS, MRD remains the best stem cell source followed by 8 of 8 MUD. Transplantation from 7 of 8 MUD is associated with significantly poorer outcomes.
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI;
authors.forename: Wael
authors.initials: W
authors.lastname: Saber
authors.forename: Corey S
authors.initials: CS
authors.lastname: Cutler
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Nakamura
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.forename: Ehab
authors.initials: E
authors.lastname: Atallah
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Rizzo
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Matt E
authors.initials: ME
authors.lastname: Kalaycio
authors.forename: Mary M
authors.initials: MM
authors.lastname: Horowitz
mesh_terms: D000328:Adult; D000368:Aged; D001782:Blood Donors; D005260:Female; D015234:HLA-A Antigens / Q000276:immunology; D015235:HLA-B Antigens / Q000276:immunology; D015236:HLA-C Antigens / Q000276:immunology; D059811:HLA-DRB1 Chains / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D016019:Survival Analysis; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D015234:HLA-A Antigens; D015235:HLA-B Antigens; D015236:HLA-C Antigens; D059811:HLA-DRB1 Chains