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Acute Leukemias

Predictive impact of allele-matching and EBMT risk score for outcome after T-cell depleted unrelated donor transplantation in poor-risk acute leukemia and myelodysplasia

Leukemia volume 25, pages 1548–1554 (2011)Cite this article

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Abstract

Many parameters predict for outcome after unrelated donor (URD) allogeneic hematopoietic stem cell transplantation (alloSCT). High-resolution HLA-matching significantly impacts outcome and also the European Group of Blood and Marrow Transplantation (EBMT) risk score, based on patient age, disease stage, donor type, time from diagnosis to SCT and gender combination, may predict for non-relapse mortality and overall survival (OS). We evaluated the individual and combined effects of allele-matching and the EBMT risk score in 327 patients with poor-risk acute leukemia or myelodysplasia, who received a T-cell depleted URD alloSCT. Matching for HLA-A, -B, -C and -DRB1 alleles (8/8 match) was associated with a 5-year OS of 40% compared with 30% for mismatched (⩽7/8) pairs (P=0.02). Patients with EBMT risk scores of 1–2, 3, 4 and 5–7 had 5-year OS estimates of 53, 43, 30 and 20%, respectively (P<0.001). The favorable prognostic impact of an 8/8 donor was most pronounced if the EBMT risk score was low (1–2). Five-year OS was 74±8% vs 39±11% for fully matched patients with a low-risk EBMT score as compared with EBMT low-risk patients with ⩽7/8 donors. These data underscore the importance of incorporating both the EBMT risk score and the degree of high-resolution HLA-matching in the risk assessment prior to URD alloSCT.

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Authors and Affiliations

  1. Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands

    T Lodewyck, L Duinhouwer, B Lowenberg, E Meijer & J J Cornelissen

  2. Europdonor Foundation and Department of Immunohematology & Blood Transfusion Service, Leiden University Medical Center, Leiden, The Netherlands

    M Oudshoorn

  3. Trials & Statistics—HOVON Data Center, Erasmus University Medical Center/Daniel den Hoed, Rotterdam, The Netherlands

    B van der Holt

  4. Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands

    E Petersen

  5. Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands

    E Spierings

  6. Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands

    P A von dem Borne & R Willemze

  7. Department of Hematology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    A Schattenberg

  8. Laboratory for Medical Immunology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    W Allebes

  9. HOVON Data Center, Erasmus University Medical Center, Rotterdam, The Netherlands

    M Groenendijk-Sijnke

  10. Department of Internal Medicine, Isala Clinics, Zwolle, The Netherlands

    L F Verdonck

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Lodewyck, T., Oudshoorn, M., van der Holt, B. et al. Predictive impact of allele-matching and EBMT risk score for outcome after T-cell depleted unrelated donor transplantation in poor-risk acute leukemia and myelodysplasia. Leukemia 25, 1548–1554 (2011). https://doi.org/10.1038/leu.2011.123

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