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-DRB1, HLA-DQB1 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.

Prognostic Factors Affecting Outcome after Allogeneic Transplantation for Hematological Malignancies from Unrelated Donors: Results from a Randomized Trial / Finke, Jürgen; Schmoor, Claudia; Bethge, Wolfgang A.; Ottinger, Hellmut D.; Stelljes, Matthias; Zander, Axel R.; Volin, Liisa; Heim, Dominik A.; Schwerdtfeger, Rainer; Kolbe, Karin; Mayer, Jiri; Maertens, Johan A.; Linkesch, Werner; Holler, Ernst; Koza, Vladimir; Bornhäuser, Martin; Einsele, Hermann; Bertz, Hartmut; Grishina, Olga; Socié, Gérard; Schneeberger, H.; Börner, G.; Gamperl, H. J.; Jauch, J.; Petan, J.; Kainz, A.; Schmoor, C.; Grishina, O.; Müller, C. h.; Scheele, J.; Schilling, B.; Kaufmann, M.; Tostmann, R.; Kollmer, A.; Nuss, S.; Wenig, C.; Bertz, H.; Egger, M.; Bethge, W. A.; Einsele, H.; Müller, R. K. F.; Ḧntschel, M.; Ottinger, H. D.; Trenschel, R.; Stelljes, M.; Zander, A. R.; Kröger, N. M.; Ayuketang, F. A.; Wolschke, C.; Schwerdtfeger, R.; Kaltenḧuser, J.; Stübig, T.; Taube, R. H.; Kolbe, K.; Thomas, S.; Ullmann, A.; Schulze Bergkamen, A.; Holler, E.; Hahn, J.; Bornḧuser, M.; Kolb, H. J.; Reibke, R.; Wandt, H.; Schaefer Eckart, K.; Socie, G.; Gluckman, E.; Esperou, H.; Robin, M.; Michallet, M.; Nicolini, F.; Null, Buzyn A.; Rubio, M. T.; Yakoub Agha, I.; Jouet, J. P.; Petillon, M. O.; Bordigoni, P.; Clement, L.; Salmon, A.; Feugier, P.; Ruutu, T.; Volin, L.; Juvonen, E.; Nihtinen, A.; Remes, K.; Putkonen, M.; Iẗl̈, M.; Kauppila, ; Mayer, J.; Krejci, M.; Brychtova, Y.; Koza, V.; Karas, M.; Voglova, J.; Lebavy, J.; Zak, P.; Heim, D.; Gratwohl, A.; Passweg, J.; Arber, C.; Tsakiris, A.; Linkesch, W.; Reitter, S.; Staber, P. B.; Lutz, D.; Krieger, O.; Maertens, J. A.; Theunissen, K.; Boogaerts, M.; Verhoef, G.; Rowe, J.; Rosenvald Zuckermann, T.; Shapira, M.; Or, R.; Resnik, I.; Nagler, A.; Shimoni, A.; Yerushalmi, R.; Sierra, J.; Valcarcel, D.; Perez Simon, J. A.; Astorga, M.; Bosi, Alberto; Guidi, S.. - In: BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION. - ISSN 1083-8791. - ELETTRONICO. - 18:(2012), pp. 1716-1726. [10.1016/j.bbmt.2012.06.001]

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

BOSI, ALBERTO;
2012

Abstract

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-DRB1, HLA-DQB1 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.
2012
18
1716
1726
Finke, Jürgen; Schmoor, Claudia; Bethge, Wolfgang A.; Ottinger, Hellmut D.; Stelljes, Matthias; Zander, Axel R.; Volin, Liisa; Heim, Dominik A.; Schwerdtfeger, Rainer; Kolbe, Karin; Mayer, Jiri; Maertens, Johan A.; Linkesch, Werner; Holler, Ernst; Koza, Vladimir; Bornhäuser, Martin; Einsele, Hermann; Bertz, Hartmut; Grishina, Olga; Socié, Gérard; Schneeberger, H.; Börner, G.; Gamperl, H. J.; Jauch, J.; Petan, J.; Kainz, A.; Schmoor, C.; Grishina, O.; Müller, C. h.; Scheele, J.; Schilling, B.; Kaufmann, M.; Tostmann, R.; Kollmer, A.; Nuss, S.; Wenig, C.; Bertz, H.; Egger, M.; Bethge, W. A.; Einsele, H.; Müller, R. K. F.; Ḧntschel, M.; Ottinger, H. D.; Trenschel, R.; Stelljes, M.; Zander, A. R.; Kröger, N. M.; Ayuketang, F. A.; Wolschke, C.; Schwerdtfeger, R.; Kaltenḧuser, J.; Stübig, T.; Taube, R. H.; Kolbe, K.; Thomas, S.; Ullmann, A.; Schulze Bergkamen, A.; Holler, E.; Hahn, J.; Bornḧuser, M.; Kolb, H. J.; Reibke, R.; Wandt, H.; Schaefer Eckart, K.; Socie, G.; Gluckman, E.; Esperou, H.; Robin, M.; Michallet, M.; Nicolini, F.; Null, Buzyn A.; Rubio, M. T.; Yakoub Agha, I.; Jouet, J. P.; Petillon, M. O.; Bordigoni, P.; Clement, L.; Salmon, A.; Feugier, P.; Ruutu, T.; Volin, L.; Juvonen, E.; Nihtinen, A.; Remes, K.; Putkonen, M.; Iẗl̈, M.; Kauppila, ; Mayer, J.; Krejci, M.; Brychtova, Y.; Koza, V.; Karas, M.; Voglova, J.; Lebavy, J.; Zak, P.; Heim, D.; Gratwohl, A.; Passweg, J.; Arber, C.; Tsakiris, A.; Linkesch, W.; Reitter, S.; Staber, P. B.; Lutz, D.; Krieger, O.; Maertens, J. A.; Theunissen, K.; Boogaerts, M.; Verhoef, G.; Rowe, J.; Rosenvald Zuckermann, T.; Shapira, M.; Or, R.; Resnik, I.; Nagler, A.; Shimoni, A.; Yerushalmi, R.; Sierra, J.; Valcarcel, D.; Perez Simon, J. A.; Astorga, M.; Bosi, Alberto; Guidi, S.
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1046283
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