Faculty Collaboration Database

Significant improvement in survival after unrelated donor hematopoietic cell transplantation in the recent era. Biol Blood Marrow Transplant 2015 Jan;21(1):142-50

Date

12/03/2014

Pubmed ID

25445638

Pubmed Central ID

PMC4272902

DOI

10.1016/j.bbmt.2014.10.001

Scopus ID

2-s2.0-84927152756 (requires institutional sign-in at Scopus site)   56 Citations

Abstract

Patients and physicians may defer unrelated donor hematopoietic cell transplantation (HCT) as curative therapy because of the mortality risk associated with the procedure. Therefore, it is important for physicians to know the current outcomes data when counseling potential candidates. To provide this information, we evaluated 15,059 unrelated donor hematopoietic cell transplant recipients between 2000 and 2009. We compared outcomes before and after 2005 for 4 cohorts: age <18 years with malignant diseases (n = 1920), ages 18 to 59 years with malignant diseases (n = 9575), ages ≥ 60 years with malignant diseases (n = 2194), and nonmalignant diseases (n = 1370). Three-year overall survival in 2005 to 2009 was significantly better in all 4 cohorts (<18 years: 55% versus 45%, 18 to 59 years: 42% versus 35%, ≥ 60 years: 35% versus 25%, nonmalignant diseases: 69% versus 60%; P < .001 for all comparisons). Multivariate analyses in leukemia patients receiving HLA 7/8 to 8/8-matched transplants showed significant reduction in overall and nonrelapse mortality in the first year after HCT among patients who underwent transplantation in 2005 to 2009; however, risks for relapse did not change over time. Significant survival improvements after unrelated donor HCT have occurred over the recent decade and can be partly explained by better patient selection (eg, HCT earlier in the disease course and lower disease risk), improved donor selection (eg, more precise allele-level matched unrelated donors) and changes in transplantation practices.

Author List

Majhail NS, Chitphakdithai P, Logan B, King R, Devine S, Rossmann SN, Hale G, Hartzman RJ, Karanes C, Laport GG, Nemecek E, Snyder EL, Switzer GE, Miller J, Navarro W, Confer DL, Levine JE

Author

Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Antineoplastic Agents
Child
Child, Preschool
Female
Graft vs Host Disease
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Histocompatibility Testing
Humans
Immunosuppressive Agents
Male
Middle Aged
Survival Analysis
Time Factors
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome
Unrelated Donors