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Unrelated Donor Transplants

Unrelated donor BMT recipients given pretransplant low-dose antithymocyte globulin have outcomes equivalent to matched sibling BMT: a matched pair analysis

Bone Marrow Transplantation volume 30, pages 681–686 (2002)Cite this article

Abstract

Fifty-seven patients receiving unrelated donor (UD) BMT were matched for disease and stage with 57 recipients of genotypically matched related donor (MRD) BMT. All UD recipients were matched serologically for A and B and by high resolution for DR and DQ antigens. All patients received CsA and ‘short course’ methotrexate with folinic acid. Unrelated donor BMT patients also received thymoglobulin 4.5 mg/kg (6 mg/kg if <30 kg) in divided doses over 3 days pretransplant. For UD and RD BMT, respectively, incidence of acute GVHD grade II–IV was 19 ± 6% vs 36 ± 8%, grade III–IV 10 ± 6% vs 18 ± 7%, chronic GVHD 44 ± 8% vs 51 ± 8%, non-relapse mortality 15 ± 5% vs 8 ± 4% at 100 days, 28 ± 8% vs 36 ± 7% at 3 years. At 3 years, relapse was 45 ± 7% vs 42 ± 7%, and disease-free survival 39 ± 7% vs 37 ± 7%. None of these differences are significant. Three-year overall survival was identical at 42 ± 7%. For 29 patients with low/intermediate risk leukemia, disease-free survival was 68 ± 10% after UD BMT vs 59 ± 9% for RD BMT recipients (P = NS). Corresponding figures for high risk patients were 14 ± 7% and 21 ± 8%, respectively. We conclude that UD BMT recipients matched as above and given pretransplant ATG have similar outcomes to recipients of MRD BMT using conventional drug prophylaxis. Unrelated donor BMT should be considered in any circumstance where MRD BMT is routine.

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References

  1. Hansen J, Gooley T, Martin P et al. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia New Engl J Med 1998 338: 962 968

    Article  CAS  Google Scholar 

  2. Petersdorf EW, Longton GM, Anasetti C et al. The significance of HLA-DRB1 matching on clinical outcome after HLA-A, B, DR identical unrelated donor marrow transplantation Blood 1995 86: 1606 1613

    CAS  Google Scholar 

  3. Speiser DE, Tiercy JM, Rufer N et al. High resolution HLA matching associated with decreased mortality after unrelated bone marrow transplantation Blood 1996 87: 4455 4462

    CAS  Google Scholar 

  4. Petersdorf EW, Goolet TA, Anasetti C et al. Optimizing outcome after unrelated marrow transplantation by comprehensive matching of HLA class I and II alleles in the donor and recipient Blood 1998 92: 3515 3520

    CAS  Google Scholar 

  5. Sasazuki T, Juji T, Morishima I et al. Effect of matching of class I HLA alleles on clinical outcome after transplantation of hematopoietic stem cells from an unrelated donor New Engl J Med 1998 339: 1177 1185

    Article  CAS  Google Scholar 

  6. Gajewski J, Gjertson D, Cecka M et al. The impact of T-cell depletion on the effects of DRB1 and DQB1 allele matching in HLA serologically identical unrelated donor bone marrow transplantation Biol Blood Marrow Transplant 1997 3: 76 82

    CAS  PubMed  Google Scholar 

  7. Ringden O, Remberger M, Carlens S et al. Low incidence of acute graft-versus-host disease, using unrelated HLA-A-, HLA-B-, and HLA-DR-compatible donors and conditioning, including anti-T-cell antibodies Transplantation 1998 66: 620 625

    Article  CAS  Google Scholar 

  8. Byrne JL, Stainer C, Cull G et al. The effect of the serotherapy regimen used and the marrow cell dose received on rejection, graft-versus-host disease, and outcome following unrelated donor bone marrow transplantation for leukemia Bone Marrow Transplant 2000 25: 411 417

    Article  CAS  Google Scholar 

  9. Souillet G, Rey S, Bertrand Y et al. Rabbit ATG (Thymoglobulin)-based regimen in matched or mismatched unrelated donor paediatric BMT Blood 1999 94: 564a (Abstr. 2519)

    Google Scholar 

  10. Finke J, Bertz H, Veelken H et al. In vivo T cell depletion with ATG reduces GVHD in unrelated donor stem cell transplantation Blood 1999 94: 713a (Abstr. 3148)

    Google Scholar 

  11. Ringden O, Remberger M, Persson U et al. Similar incidence of graft-versus-host disease using HLA-A, -B and -DR identical unrelated bone marrow donors as with HLA-identical siblings Bone Marrow Transplant 1995 15: 619 625

    CAS  Google Scholar 

  12. Baurmann H, Revillard JP, Bonnefoy-Berard N, Schwerdfeger R . Potent effects of ATG used as part of the conditioning in matched unrelated donor (MUD) transplantation Blood 1998 92: 290a (Abstr. 1188)

    Google Scholar 

  13. Remberger M, Svahn BM, Hentschke P et al. Effect on cytokine release and graft-versus-host disease of different anti-T cell antibodies during conditioning for unrelated haematopoietic stem cell transplantation Bone Marrow Transplant 1999 24: 823 830

    Article  CAS  Google Scholar 

  14. Kröger N, Zabelina T, Küger H et al. Anti-human T-lymphocyte globulin (ATG) as part of conditioning regimen in unrelated bone marrow transplantation of patients with CML in chronic or accelerated phase Blood 1998 92: 144a (Abstr. 578)

    Google Scholar 

  15. Zander AR, Zabelina T, Kröger N et al. Use of a five-agent GVHD prevention regimen in recipients of unrelated donor marrow Bone Marrow Transplant 1999 23: 889 893

    Article  CAS  Google Scholar 

  16. Russell JA, Chaudhry A, Booth K et al. Early outcomes after allogeneic stem cell transplantation for leukemia and myelodysplasia without protective isolation: a 10-year experience Biol Blood Marrow Transplant 2000 6: 109 114

    Article  CAS  Google Scholar 

  17. Russell JA, Woodman RC, Poon M-C et al. Addition of low-dose folinic acid to a methotrexate/cyclosporin regimen for prevention of acute graft-versus-host disease Bone Marrow Transplant 1994 14: 397 401

    CAS  PubMed  Google Scholar 

  18. Barrett J . Graft-versus-host disease In: Treleaven J, Barrett J (eds) Bone Marrow Transplantation in Practice Churchill Livingstone: Edinburgh 1992 p 257

    Google Scholar 

  19. Report on state of the art in blood and marrow transplantation – the IBMTR/ABMTR summary slides with guide IBMTR/ABMTR Newsletter 2000 7: 3 10

  20. Szydlo R, Goldman JM, Klein JP et al. Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings J Clin Oncol 1997 15: 1767 1777

    Article  CAS  Google Scholar 

  21. Chaudhry MA, Duggan P, Brown CB et al. Myeloablative chemotherapy for allogeneic transplantation with a fludarabine/busulfan protocol (FLUBUP): comparison with BUCY Biol Blood Marrow Transplant 2000 2: 140 (Abstr. 24)

    Google Scholar 

  22. Russell JA, Chaudhry AM, Duggan P et al. Daily intravenous busulfan (BU): comparison with conventional oral BU in combination with fludarabine as conditioning for allogeneic stem cell transplant Blood 2000 96: 3336 (Abstr. 5188)

    Google Scholar 

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Acknowledgements

Our thanks are due to the nursing staff at Foothills Hospital, Alberta Children's Hospital and the Cross Cancer Institute for their care of these patients.

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Authors and Affiliations

  1. Departments of Medicine and Oncology, Foothills Hospital, Calgary, Alberta, Canada

    P Duggan, A Chaudhry, D Stewart, JD Ruether, S Glück, D Morris, CB Brown, B Herbut & JA Russell

  2. Departments of Medicine and Oncology, Alberta Children's Hospital, Calgary, Alberta, Canada

    K Booth, M Coppes, R Anderson, J Wolff, M Egeler & JA Russell

  3. Departments of Medicine and Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada

    P Duggan, A Chaudhry, D Stewart, JD Ruether, S Glück, D Morris, CB Brown, E Gyonyor & JA Russell

  4. Department of Medicine and Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada

    S Desai, AR Turner & L Larratt

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  1. P Duggan
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  18. JA Russell
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for Alberta Blood and Bone Marrow Transplant Program

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Duggan, P., Booth, K., Chaudhry, A. et al. Unrelated donor BMT recipients given pretransplant low-dose antithymocyte globulin have outcomes equivalent to matched sibling BMT: a matched pair analysis. Bone Marrow Transplant 30, 681–686 (2002). https://doi.org/10.1038/sj.bmt.1703674

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