학술논문

In patients older than 55 years with AML in first CR, should we search for a matched unrelated donor when an old sibling donor is available?
Document Type
Article
Source
Bone Marrow Transplantation. Nov2015, Vol. 50 Issue 11, p1411-1415. 5p. 2 Charts, 1 Graph.
Subject
*GRAFT versus host disease
*HEMATOLOGIC malignancies
*HEMATOPOIETIC stem cell transplantation
*ORGAN donors
*DISEASE relapse
*THERAPEUTICS
Language
ISSN
0268-3369
Abstract
Allogeneic hematopoietic transplantation is increasingly used in patients aged 55 years or more with AML. The question of whether outcomes can be improved with an allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD, more than 55 years) is still unanswered. We thus analyzed outcomes in 714 patients aged 55 years and older with AML in first CR (CR1) who received PBSCs after a reduced-intensity conditioning hematopoietic cell transplant from a MUD (n=310) or a MSD (n=404) in a recent period (2005-2010). The 3-year cumulative incidences (CIs) of non-relapse mortality were 17% and 23% with MSD and MUD, respectively (P=0.17). The 3-year CIs of relapse were 37% and 30%, respectively (P=0.12), resulting in a 3-year CI of leukemia-free survival of 46% and 47%, respectively (P=0.51). The 3-year overall survival was 49% with both MSD and MUD. In conclusion, HLA-identical sibling donors aged 55 years or more should not be excluded because of age for patients aged 55 years and older with AML in CR1. [ABSTRACT FROM AUTHOR]