TY - JOUR
T1 - Prognostic Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Adults with Chronic Myelomonocytic Leukemia
T2 - A Nationwide Retrospective Analysis in Japan
AU - Itonaga, Hidehiro
AU - Aoki, Kazunari
AU - Aoki, Jun
AU - Ishikawa, Takayuki
AU - Ishiyama, Ken
AU - Uchida, Naoyuki
AU - Sakura, Toru
AU - Ohashi, Kazuteru
AU - Kurokawa, Mineo
AU - Ozawa, Yukiyasu
AU - Matsuoka, Ken ichi
AU - Nakamura, Yukinori
AU - Kimura, Fumihiko
AU - Iwato, Koji
AU - Nawa, Yuichiro
AU - Hirokawa, Makoto
AU - Kato, Koji
AU - Ichinohe, Tatsuo
AU - Atsuta, Yoshiko
AU - Miyazaki, Yasushi
N1 - Funding Information:
Financial disclosure: This work was supported in part by the Practical Research Project ( JP16ek0510004 ) for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development.
Publisher Copyright:
© 2017 The American Society for Blood and Marrow Transplantation
PY - 2018/4
Y1 - 2018/4
N2 - Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapeutic option for patients with chronic myelomonocytic leukemia (CMML). We retrospectively compared the post-transplantation outcomes of 159 patients with CMML who underwent allo-HSCT using 4 types of donor sources: HLA-matched related donor graft, unrelated bone marrow (U-BM), unrelated cord blood (U-CB), and HLA-mismatched related donor graft. The median patient age at allo-HSCT was 54 years (range, 16 to 75 years). In multivariate analyses, the use of HLA-matched related donor grafts correlated with better overall survival than U-BM (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.21 to 3.48; P =.008), U-CB (HR, 3.80; 95% CI, 2.07 to 6.95; P <.001), or HLA-mismatched related donor grafts (HR, 6.18; 95% CI, 2.70 to 14.15; P <.001). Mortality after the relapse or progression of CMML did not significantly differ among the 4 types of donor source. Transplantation-related mortality was highest in recipients of U-CB (HR, 3.32; 95% CI, 1.33 to 8.26; P =.010). In patients with CMML, allo-HSCT using an alternative donor may contribute to durable remission; however, further improvements in transplantation-related mortality are required for this type of transplantation.
AB - Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapeutic option for patients with chronic myelomonocytic leukemia (CMML). We retrospectively compared the post-transplantation outcomes of 159 patients with CMML who underwent allo-HSCT using 4 types of donor sources: HLA-matched related donor graft, unrelated bone marrow (U-BM), unrelated cord blood (U-CB), and HLA-mismatched related donor graft. The median patient age at allo-HSCT was 54 years (range, 16 to 75 years). In multivariate analyses, the use of HLA-matched related donor grafts correlated with better overall survival than U-BM (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.21 to 3.48; P =.008), U-CB (HR, 3.80; 95% CI, 2.07 to 6.95; P <.001), or HLA-mismatched related donor grafts (HR, 6.18; 95% CI, 2.70 to 14.15; P <.001). Mortality after the relapse or progression of CMML did not significantly differ among the 4 types of donor source. Transplantation-related mortality was highest in recipients of U-CB (HR, 3.32; 95% CI, 1.33 to 8.26; P =.010). In patients with CMML, allo-HSCT using an alternative donor may contribute to durable remission; however, further improvements in transplantation-related mortality are required for this type of transplantation.
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U2 - 10.1016/j.bbmt.2017.11.016
DO - 10.1016/j.bbmt.2017.11.016
M3 - Article
C2 - 29196081
AN - SCOPUS:85039048450
SN - 1083-8791
VL - 24
SP - 840
EP - 848
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 4
ER -