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Genotypically nonidentical related donors for transplantation of patients with myelodysplastic syndromes: comparison with unrelated donor transplantation and autologous stem cell transplantation

Leukemia volume 15, pages 1878–1884 (2001)Cite this article

Abstract

Transplantation with histocompatible identical siblings is a curative treatment for patients with myelodysplastic syndromes (MDS). Alternative treatments, such as transplantation with other family donors, are an option for patients without HLA-identical siblings. This study evaluated transplantation with genotypically nonidentical family donors and compared the results to those obtained with unrelated donors and autologous stem cell transplantation. Overall 3-year survival was 35% for the 79 patients transplanted using genotypically nonidentical donors, DFS was 31%, relapse risk 16%, and the treatment-related mortality (TRM) 62%. Patients transplanted using phenotypically identical family donors had a significantly superior survival and a lower TRM than patients transplanted with mismatched family donors. Age had no influence on the outcome of transplantation. The DFS of patients transplanted in early stage of the disease was 42% compared to 28% in patients transplanted with more advanced disease (P = 0.03). The results of transplantation with mismatched family donors were comparable to those obtained with unrelated donor transplantation. This suggests that nonidentical family donors may be considered if a fully matched unrelated donor is not available. The TRM of patients transplanted with nonidentical family donors is significantly higher than the TRM of patients transplanted with autologous stem cells. The disease-free survival of ASCT is not inferior to allogeneic transplantation using nonidentical family donors, and the intensity of the treatment is much lower. The choice of ASCT or alternative donor transplantation must be influenced by the age of the patient and the risk of relapse. For patients under the age of 20 years the treatment of choice may indeed be an alternative donor transplantation.

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Authors and Affiliations

  1. Department of Hematology, University Medical Center St Radboud, Nijmegen, The Netherlands

    T de Witte & F Pikkemaat

  2. Department of Medical Statistics, Leiden University Medical Center, The Netherlands

    J Hermans

  3. Chronic Leukaemia Working Party Registry Leiden, The Netherlands

    A van Biezen

  4. Department of Haematology, University College London Medical School, London, UK

    S Mackinnan

  5. Daniel den Hoedt Hospital, Rotterdam, The Netherlands

    J Cornelissen

  6. Division of Hematology, Department of Internal Medicine, Kantonsspital, Basel, Switzerland

    A Gratwohl

  7. Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium

    M Delforge

  8. Hospital University of Marques de Valdécilla, Santander, Spain

    A Iriondo

  9. Service d'Hematologie, Hôpital Henri Mondor, Creteil, France

    M Kuentz

  10. Departement d'Hematologie, Hotel Dieu, Nantes, France

    J Harousseau

  11. Klinik für KMT, Hamatologie und Onkologie, Idar-Oberststein, Germany

    A Fauser

  12. 5. Medizinische Klinik, BMT-Unit, Klinikum Nürnberg, Germany

    H Wandt

  13. Department of Bone Marrow Transplantation, University Hospital, Essen, Germany

    V Runde

  14. Department of Internal Medicine, University Hospital, Leipzig, Germany

    D Niederwieser

  15. Department of Hematology, Imperial College School of Medicine, London, UK

    J Apperley

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  1. T de Witte
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for the EBMT, CLWP-MDS subcommittee, University Medical Center, Nijmegen, The Netherlands

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de Witte, T., Pikkemaat, F., Hermans, J. et al. Genotypically nonidentical related donors for transplantation of patients with myelodysplastic syndromes: comparison with unrelated donor transplantation and autologous stem cell transplantation. Leukemia 15, 1878–1884 (2001). https://doi.org/10.1038/sj.leu.2402296

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