HLA match is only donor characteristic affecting HCT outcomes
This study of donor characteristics on the outcomes of 709 unrelated donor transplants has found that while donor-recipient HLA match has a significant influence on outcomes, donor age, parity (previous donor pregnancy), and donor sex match did not. The study examined transplant outcomes of reduced-intensity transplants from 1999-2006 in the United States facilitated by the NMDP. Multivariate analysis found that a 1- or 2-HLA mismatch was significantly associated with higher grade II-IV acute GVHD (relative risk [RR]=1.27, p=0.035) and grade III-IV acute GVHD (RR=1.85, p<0.001). Two-loci HLA mismatches were also associated with higher mortality (RR=2.22, p<0.001).
This large-scale retrospective study determined the cumulative incidence of late effects following hematopoietic cell transplantation (HCT) performed at Fred Hutchinson Cancer Research Center between 2004-2009. From annual surveys and medical records of 1087 recipients, researchers determined the incidence of 14 different nonmalignant conditions such as osteoporosis, diabetes mellitus, or coronary artery disease. The 5-year cumulative incidence of at least one nonmalignant complication was 44.8% in autologous recipients and 79% in allogeneic recipients. Three or more late effects were reported by 2.5% of autologous recipients and 25.5% of allogeneic recipients.
A retrospective cohort study of 885 umbilical cord blood transplant (UCBT) recipients (612 whites, 145 blacks, and 128 Hispanics) has found that 2-year overall survival differed according to race/ethnicity: 44% for whites, 34% for blacks, and 46% for Hispanics (p=0.008). The study analyzed outcomes in patients with leukemia and myelodysplastic syndromes undergoing single-unit UCBT from 1995-2006 and reported to CIBMTR (Center for International Blood and Marrow Transplant Research). However, the study also found that when using well-matched cord blood units with higher cell doses, black patients and white patients had comparable survival.
A meta-analysis pooling results of 7 published randomized phase III controlled trials (total n=733) has found that antithymocyte globulin (ATG) can significantly reduce the incidence of grade III-IV acute GVHD. Patients receiving ATG had a combined a risk ratio (RR) of 0.51 when compared to patients not receiving ATG (p=0.03). However, ATG had no effect on rates of grade II acute GVHD (RR=0.79; p=0.35) or grade I acute GVHD (RR=1.42; p=0.28). ATG was also not associated with a significant reduction in the incidence of non-relapse mortality (RR=0.74; p=0.08).
Management of Advanced Non-Hodgkin Lymphomas four-part CME series reviews treatment options for follicular, mantle cell, diffuse large B-cell, and T-cell lymphomas. Learn about first- and second-line treatment options for relapsed/refractory patients, including novel agents, and both allogeneic and autologous transplantation. Access NHL CME program »
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