In this multi-center study of patients with high-risk myelodysplastic syndromes (MDS) or secondary AML (sAML), undergoing HCT was associated with better long-term overall survival compared to receiving azacitidine (AZA) therapy. In this retrospective balanced-cohort study, 103 patients with high-risk MDS/sAML who underwent HCT were compared to 75 MDS patients receiving AZA. All patients were between 60-70 years old. A multivariate analysis revealed three factors significantly associated with greater overall survival: cytogenetics (good vs. intermediate vs. poor; hazard ratio [HR], 1.2/1.7; p=0.026), ECOG score (0 vs. 1 vs. 2; HR, 2.9/3.9; p<0.001), and treatment (HCT vs. AZA; HR, 0.3; p=0.007).
A multi-center study of 248 adults (median age 52 years, range 18-72) undergoing reduced-intensity HCT for non-Hodgkin lymphoma (NHL) using unrelated (n=222) and related (n=26) donors. Outcomes were reported to the CIBMTR (Center for International Blood and Marrow Transplant Research). Grade II-IV acute GVHD at 100 days was 43%, and chronic GVHD at three years was 44%. Overall and progression-free survival at three-years post HCT were 41% and 32%, respectively. In a multivariate analysis, use of antithymocyte globulin and HLA mismatch were associated with increased transplant-related mortality.
Donor-recipient sex combination more important than donor type for AML in CR1
A retrospective, multi-center study of 605 patients with intermediate-risk acute myeloid leukemia (AML) in first complete remission (CR1) has found that males may have better transplant outcomes using a male matched unrelated donor rather than a female matched related donor. In this study, four-year overall survival (OS) was 65% for matched related HCT and 68% for matched unrelated donor HCT (p=0.50). In unrelated donor HCT with sex combinations other than female donor/male recipient, four-year OS was significantly higher compared to matched related HCT from female donors to male recipients: 72% vs. 55%; p=0.04. The authors conclude the donor-recipient sex combination may be more important than the donor type in donor selection in this patient population.
A single-center, retrospective study of 210 pediatric (<13 years) bone marrow donors, examining procedures of donor eligibility and immediate post-donation effects. The researchers also prospectively studied a cohort of childhood donors on long-term health and quality-of-life factors. Of 197 donors with analyzable data, 13 (6.6%) had existing medical conditions possibly affecting the safety of the donation. Only 24 donors had documented follow-up within 100 days of donation. The authors conclude that there is a need for “independent medical assessment of child donors, especially in children with preexisting medical conditions to avoid peri-donation events.”
The recommendations on the diagnosis and management of acute GVHD outlined in this position paper reflect the consensus opinion of HCT experts from two British professional organizations. The recommendations include GVHD grading criteria, specific recommendations based on severity of disease and organ(s) involved, primary treatment options, and second- and third-line treatment options for patients with steroid-refractory disease.
Special Edition Newsletter Highlights CIBMTR Research
In celebration of the 40th anniversary of CIBMTR (Center for International Blood and Marrow Transplant Research), the NMDP has released a special edition of its Advances in Transplantation newsletter. This edition highlights the tremendous impact of CIBMTR research, and features 12 of the more than 700 publications from CIBMTR. View newsletter (PDF) »
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