Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial

Several prognostic factors for the outcome after allogeneic hematopoietic stem-cell transplant (HSCT) from matched unrelated donors have been postulated from registry data; however, data from randomized trials are lacking. We present analyses on the effects of patient-related, donor-related, and tre...

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Autores: Finke, J, Schmoor, C, Bethge, WA, Ottinger, HD, Stelljes, M, Zander, AR, Volin, L, Heim, DA, Schwerdtfeger, R, Kolbe, K, Mayer, J, Maertens, JA, Linkesch, W, Holler, E, Koza, V, Bornhauser, M, Einsele, H, Bertz, H, Grishina, O, Socie, G, Sierra J., ATG-Fresenius Trial Grp
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2012
País:España
Recursos:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p11052
Acesso em linha:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11052
Access Level:acceso abierto
Palavra-chave:Allogeneic hematopoietic stem-cell transplantation
Graft-versus-host-disease prophylaxis
HLA-matching
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spelling Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized TrialFinke, JSchmoor, CBethge, WAOttinger, HDStelljes, MZander, ARVolin, LHeim, DASchwerdtfeger, RKolbe, KMayer, JMaertens, JALinkesch, WHoller, EKoza, VBornhauser, MEinsele, HBertz, HGrishina, OSocie, GSierra J.ATG-Fresenius Trial GrpAllogeneic hematopoietic stem-cell transplantationGraft-versus-host-disease prophylaxisHLA-matchingSeveral prognostic factors for the outcome after allogeneic hematopoietic stem-cell transplant (HSCT) from matched unrelated donors have been postulated from registry data; however, data from randomized trials are lacking. We present analyses on the effects of patient-related, donor-related, and treatment-related prognostic factors on acute GVHD (aGVHD), chronic GVHD (cGVHD), relapse, nonrelapse mortality (NRM), disease-free survival (DFS), and overall survival (OS) in a randomized, multicenter, open-label, phase III trial comparing standard graft-versus-host-disease (GVHD) prophylaxis with and without pretransplantation ATG-Fresenius (ATG-F) in 201 adult patients receiving myeloablative conditioning before HSCT from HLA-A, HLA-B antigen, HLA-DRBI, HLA-DQBI allele matched unrelated donors. High-resolution testing (allele) of HLA-A, HLA-B, and HLA-C were obtained after study closure, and the impact of an HLA 10/10 4-digit mismatch on outcome and on the treatment effect of ATG-F versus control investigated. Advanced disease was a negative factor for relapse, DFS, and OS. Donor age >= 40 adversely affected the risk of aGVHD III-IV, extensive cGVHD, and OS. Younger donors are to be preferred in unrelated donor transplantation. Advanced disease patients need special precautions to improve outcome. The degree of mismatch had no major influence on the positive effect of ATG-F on the reduction of aGVHD and cGVHD. Biol Blood Marrow Transplant 18: 1716-1726 (2012) (C) 2012 American Society for Blood and Marrow TransplantationELSEVIER SCIENCE INC2012info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11052BIOLOGY OF BLOOD AND MARROW TRANSPLANTATIONISSN: 10838791ISSNe: 15236536reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p110522026-06-14T12:41:47Z
dc.title.none.fl_str_mv Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial
title Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial
spellingShingle Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial
Finke, J
Allogeneic hematopoietic stem-cell transplantation
Graft-versus-host-disease prophylaxis
HLA-matching
title_short Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial
title_full Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial
title_fullStr Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial
title_full_unstemmed Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial
title_sort Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial
dc.creator.none.fl_str_mv Finke, J
Schmoor, C
Bethge, WA
Ottinger, HD
Stelljes, M
Zander, AR
Volin, L
Heim, DA
Schwerdtfeger, R
Kolbe, K
Mayer, J
Maertens, JA
Linkesch, W
Holler, E
Koza, V
Bornhauser, M
Einsele, H
Bertz, H
Grishina, O
Socie, G
Sierra J.
ATG-Fresenius Trial Grp
author Finke, J
author_facet Finke, J
Schmoor, C
Bethge, WA
Ottinger, HD
Stelljes, M
Zander, AR
Volin, L
Heim, DA
Schwerdtfeger, R
Kolbe, K
Mayer, J
Maertens, JA
Linkesch, W
Holler, E
Koza, V
Bornhauser, M
Einsele, H
Bertz, H
Grishina, O
Socie, G
Sierra J.
ATG-Fresenius Trial Grp
author_role author
author2 Schmoor, C
Bethge, WA
Ottinger, HD
Stelljes, M
Zander, AR
Volin, L
Heim, DA
Schwerdtfeger, R
Kolbe, K
Mayer, J
Maertens, JA
Linkesch, W
Holler, E
Koza, V
Bornhauser, M
Einsele, H
Bertz, H
Grishina, O
Socie, G
Sierra J.
ATG-Fresenius Trial Grp
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Allogeneic hematopoietic stem-cell transplantation
Graft-versus-host-disease prophylaxis
HLA-matching
topic Allogeneic hematopoietic stem-cell transplantation
Graft-versus-host-disease prophylaxis
HLA-matching
description Several prognostic factors for the outcome after allogeneic hematopoietic stem-cell transplant (HSCT) from matched unrelated donors have been postulated from registry data; however, data from randomized trials are lacking. We present analyses on the effects of patient-related, donor-related, and treatment-related prognostic factors on acute GVHD (aGVHD), chronic GVHD (cGVHD), relapse, nonrelapse mortality (NRM), disease-free survival (DFS), and overall survival (OS) in a randomized, multicenter, open-label, phase III trial comparing standard graft-versus-host-disease (GVHD) prophylaxis with and without pretransplantation ATG-Fresenius (ATG-F) in 201 adult patients receiving myeloablative conditioning before HSCT from HLA-A, HLA-B antigen, HLA-DRBI, HLA-DQBI allele matched unrelated donors. High-resolution testing (allele) of HLA-A, HLA-B, and HLA-C were obtained after study closure, and the impact of an HLA 10/10 4-digit mismatch on outcome and on the treatment effect of ATG-F versus control investigated. Advanced disease was a negative factor for relapse, DFS, and OS. Donor age >= 40 adversely affected the risk of aGVHD III-IV, extensive cGVHD, and OS. Younger donors are to be preferred in unrelated donor transplantation. Advanced disease patients need special precautions to improve outcome. The degree of mismatch had no major influence on the positive effect of ATG-F on the reduction of aGVHD and cGVHD. Biol Blood Marrow Transplant 18: 1716-1726 (2012) (C) 2012 American Society for Blood and Marrow Transplantation
publishDate 2012
dc.date.none.fl_str_mv 2012
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11052
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11052
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
ISSN: 10838791
ISSNe: 15236536
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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