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Allografting

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.

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Acknowledgements

MR and RPL had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Author contributions: Conception and design: MR, RP, LA, GS, RPL. Provision of study materials and patients: MR, LA, NB, ER, JL, CH, AD, PF, HD, GS, RPL. Collection and assembly of the data: MR, RP, LA, GS, RPL. Data analysis and interpretation: MR, RP, LA, GS, RPL. Manuscript writing: MR, RP, LA, GS, RPL. Final approval of manuscript: MR, RP, LA, NB, ER, JL, CH, AD, PF, HD, GS, RPL.

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Correspondence to R Peffault de Latour.

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Robin, M., Porcher, R., Adès, L. et al. Matched unrelated or matched sibling donors result in comparable outcomes after non-myeloablative HSCT in patients with AML or MDS. Bone Marrow Transplant 48, 1296–1301 (2013). https://doi.org/10.1038/bmt.2013.50

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