[en] Mobilized peripheral blood has become the predominant stem cell source for allogeneic hematopoietic cell transplantation. Few studies have compared outcome of HLA-matched related and HLA-matched unrelated donor peripheral blood stem cell transplants. We conducted a retrospectivesingle-center analysis of 442 patients with hematologic malignancies who underwent peripheral blood stem cell transplantationfrom matched related or matched unrelated donorand we analyzed prognostic factors for long-term survival.To account for disease/status heterogeneity, patients were risk-stratified according to theDisease Risk Index.Five-year overall survival was similar aftertransplants with matched related and unrelated donor. Because donor age ≥60 years impacted outcome during model building, we further considered 3 groups of donors: matched unrelated donor (aged < 60 years by definition), matched related donor aged <60 yearsand matched related donoraged ≥60 years. In multivariate analysis, donor type/age groupand graft CD34+ and CD3+ cell doses significantly impactedlong-term survival. Transplants with matched unrelated donor and matched related donor<60years resulted in similar long-term survival while transplant with matched related donor≥60years was associated with higher risks for late mortality and treatment failure. Lower mortality risks were observed after transplant with CD34+ cell dose > 4.5 x 106/kgand CD3+ cell dose > 3 x 108/kg. The Disease Risk Index failed to predictsurvival. We builtan “Adapted Disease Risk Index” by modifying risks for myeloproliferative neoplasms and multiple myeloma, thatimproved stratification ability for progression-free survivalbut not for overall survival.
Disciplines :
Hematology
Author, co-author :
SERVAIS, Sophie ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Porcher, Raphael; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Hospital Saint-Louis > Biostatistics
Xhaard, Aliénor; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Hospital Saint-Louis > Hematology - Bone Marrow Unit
Robin, Marie; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Hospital Saint-Louis > Hematology - Bone Marrow Unit
Masson, Emeline; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Saint-Louis Hospital > Laboratory of Immunology and Histocompatibility
Larghero, Jerome; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Saint-Louis Hospital > Laboratory of Immunology and Histocompatibility
Ribaud, Patricia; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Saint-Louis Hospital > Hematology - Bone Marrow Unit
Dhedin, Nathalie; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Saint-Louis Hospital > Hematology - Bone Marrow Unit
Abbes, Sarah; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Saint-Louis Hospital > Hematology - Bone Marrow Unit
Sicre, Flore; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Saint-Louis Hospital > Hematology - Bone Marrow Unit
Socie, Gerard; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Saint-Louis Hospital > Hematology - Bone Marrow Unit
Peffault de Latour, Régis; University Paris Diderot, Sorbonne Paris Cité, Paris, France > Saint-Louis Hospital > Hematology - Bone Marrow Unit
Language :
English
Title :
Pre-transplant prognostic factors of long-term survival after allogeneic peripheral blood stem cell transplantation with matched related/unrelated donors
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