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Graft-Versus-Leukaemia

The graft-versus-leukaemia effect in haematopoietic stem cell transplantation using unrelated donors

Bone Marrow Transplantation volume 30, pages 761–768 (2002)Cite this article

Abstract

We studied the graft-versus-leukaemia (GVL) effect in 185 patients with haematological malignancies who underwent unrelated donor haematopoietic stem cell transplantation (HSCT) at Huddinge University Hospital between May 1991 and June 2001. Ninety-five were in first CR/CP and 90 in later stages. Most (86%) of them had a HLA-A, -B and -DRβ1 matched donor. Conditioning usually consisted of total body irradiation and cyclophosphamide, and GVHD prophylaxis of cyclosporine and methotrexate. In the multivariate risk-factor analysis of relapse, we found that disease stage beyond CR1/CP1 (P = 0.02), acute GVHD 0–I (P = 0.02), absence of chronic GVHD (P = 0.02) and ALL (P = 0.02) were independent risk factors for relapse. The incidence of relapse in those with acute GVHD grade II was 18% vs 46% in those with no or grade I (P = 0.04). In patients with or without chronic GVHD, the incidences of relapse were 32% and 48%, respectively (P < 0.01). The best RFS was seen in patients with chronic GVHD. No difference in RFS was seen in patients with no, mild or moderate acute GVHD. Risk factors for relapse after HSCT with unrelated donors were: acute lymphoblastic leukaemia, disease stage beyond CR1/CP1, absence of chronic GVHD and no, or mild acute GVHD. Overall and relapse-free survival were not improved by the occurrence of acute GVHD.

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Acknowledgements

We thank the staff at the Centre for Allogeneic Stem-cell Transplantation, Departments of Haematology and Paediatrics for excellent patient care. This study was supported by grants from Dagmar Ferbs Memorial foundation, Svenska Läkareförbundet (2000-02-0553), the Swedish Cancer Society (0070-B97-11XBC), the Children's Cancer Foundation (1997/073, 1998/002), the Swedish Medical Research Council (K98-06X-05971-18B) and the Tobias Foundation (B11/98).

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Authors and Affiliations

  1. Department of Clinical Immunology, Huddinge University Hospital, Stockholm, Sweden

    M Remberger, J Mattsson, P Hentschke & O Ringdén

  2. Centre for Allogeneic Stem Cell Transplantation, Huddinge University Hospital, Stockholm, Sweden

    M Remberger, J Mattsson, P Hentschke, J Aschan, L Barkholt, J Svennilson & O Ringdén

  3. Department of Haematology, Huddinge University Hospital, Stockholm, Sweden

    J Aschan & P Ljungman

  4. Department of Paediatrics, Huddinge University Hospital, Stockholm, Sweden

    J Svennilson

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Remberger, M., Mattsson, J., Hentschke, P. et al. The graft-versus-leukaemia effect in haematopoietic stem cell transplantation using unrelated donors. Bone Marrow Transplant 30, 761–768 (2002). https://doi.org/10.1038/sj.bmt.1703735

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