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Engraftment and survival after unrelated-donor bone marrow transplantation: a report from the national marrow donor program.
Blood. 2000 Dec 15; 96(13):4096-102.Blood

Abstract

We analyzed engraftment of unrelated-donor (URD) bone marrow in 5246 patients who received transplants facilitated by the National Marrow Donor Program between August 1991 and June 1999. Among patients surviving at least 28 days, 4% had primary graft failure (failure to achieve an absolute neutrophil count > 5 x 10(8)/L before death or second stem-cell infusion). Multivariate logistic regression analysis showed that engraftment was associated with marrow matched at HLA-A, HLA-B, and DRB1; higher cell dose; younger recipient; male recipient; and recipient from a non-African American ethnic group. More rapid myeloid engraftment was associated with marrow serologically matched at HLA-A and HLA-B, DRB1 match, higher cell dose (in non-T-cell-depleted cases), younger recipient, recipient seronegativity for cytomegalovirus (CMV), male donor, no methotrexate for graft-versus-host disease prophylaxis, and transplantation done in more recent years. A platelet count higher than 50 x 10(9)/L was achieved by 47% of patients by day 100. Conditional on survival to day 100, survival at 3 years was 61% in those with platelet engraftment at day 30, 58% in those with engraftment between day 30 and day 100, and 33% in those without engraftment at day 100 (P <.0001). Factors favoring platelet engraftment were higher cell dose, DRB1 allele match, recipient seronegativity for CMV, HLA-A and HLA-B serologically matched donor, and male donor. Secondary graft failure occurred in 10% of patients achieving initial engraftment, and 18% of those patients are alive. These data demonstrate that quality of engraftment is an important predictor of survival after URD bone marrow transplantation.

Authors+Show Affiliations

University of Minnesota, Minneapolis, MN, USA. davie008@tc.umn.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11110679

Citation

Davies, S M., et al. "Engraftment and Survival After Unrelated-donor Bone Marrow Transplantation: a Report From the National Marrow Donor Program." Blood, vol. 96, no. 13, 2000, pp. 4096-102.
Davies SM, Kollman C, Anasetti C, et al. Engraftment and survival after unrelated-donor bone marrow transplantation: a report from the national marrow donor program. Blood. 2000;96(13):4096-102.
Davies, S. M., Kollman, C., Anasetti, C., Antin, J. H., Gajewski, J., Casper, J. T., Nademanee, A., Noreen, H., King, R., Confer, D., & Kernan, N. A. (2000). Engraftment and survival after unrelated-donor bone marrow transplantation: a report from the national marrow donor program. Blood, 96(13), 4096-102.
Davies SM, et al. Engraftment and Survival After Unrelated-donor Bone Marrow Transplantation: a Report From the National Marrow Donor Program. Blood. 2000 Dec 15;96(13):4096-102. PubMed PMID: 11110679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Engraftment and survival after unrelated-donor bone marrow transplantation: a report from the national marrow donor program. AU - Davies,S M, AU - Kollman,C, AU - Anasetti,C, AU - Antin,J H, AU - Gajewski,J, AU - Casper,J T, AU - Nademanee,A, AU - Noreen,H, AU - King,R, AU - Confer,D, AU - Kernan,N A, PY - 2000/12/9/pubmed PY - 2001/2/28/medline PY - 2000/12/9/entrez SP - 4096 EP - 102 JF - Blood JO - Blood VL - 96 IS - 13 N2 - We analyzed engraftment of unrelated-donor (URD) bone marrow in 5246 patients who received transplants facilitated by the National Marrow Donor Program between August 1991 and June 1999. Among patients surviving at least 28 days, 4% had primary graft failure (failure to achieve an absolute neutrophil count > 5 x 10(8)/L before death or second stem-cell infusion). Multivariate logistic regression analysis showed that engraftment was associated with marrow matched at HLA-A, HLA-B, and DRB1; higher cell dose; younger recipient; male recipient; and recipient from a non-African American ethnic group. More rapid myeloid engraftment was associated with marrow serologically matched at HLA-A and HLA-B, DRB1 match, higher cell dose (in non-T-cell-depleted cases), younger recipient, recipient seronegativity for cytomegalovirus (CMV), male donor, no methotrexate for graft-versus-host disease prophylaxis, and transplantation done in more recent years. A platelet count higher than 50 x 10(9)/L was achieved by 47% of patients by day 100. Conditional on survival to day 100, survival at 3 years was 61% in those with platelet engraftment at day 30, 58% in those with engraftment between day 30 and day 100, and 33% in those without engraftment at day 100 (P <.0001). Factors favoring platelet engraftment were higher cell dose, DRB1 allele match, recipient seronegativity for CMV, HLA-A and HLA-B serologically matched donor, and male donor. Secondary graft failure occurred in 10% of patients achieving initial engraftment, and 18% of those patients are alive. These data demonstrate that quality of engraftment is an important predictor of survival after URD bone marrow transplantation. SN - 0006-4971 UR - https://www.unboundmedicine.com/medline/citation/11110679/Engraftment_and_survival_after_unrelated_donor_bone_marrow_transplantation:_a_report_from_the_national_marrow_donor_program_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0006-4971(20)48160-1 DB - PRIME DP - Unbound Medicine ER -