Tags

Type your tag names separated by a space and hit enter

HLA-mismatched unrelated donors are a viable alternate graft source for allogeneic transplantation following alemtuzumab-based reduced-intensity conditioning.
Blood. 2010 Jun 24; 115(25):5147-53.Blood

Abstract

The impact of human leukocyte antigen (HLA) mismatch after reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation (RIT) using unrelated donors (UD) is unclear, and may be modulated by T-cell depletion. We therefore examined outcomes of 157 consecutive patients undergoing RIT after uniform conditioning with fludarabine, melphalan, and alemtuzumab (FMC). Donors were 10/10 HLA-matched (MUDs, n = 107) and 6 to 9/10 HLA-matched (MMUDs, n = 50), with no significant differences in baseline characteristics other than increased cytomegalovirus seropositivity in MMUDs. Rates of durable engraftment were high. Graft failure rates (persistent cytopenias with donor chimerism) were similar (8% vs 3%, P = .21), though rejection (recipient chimerism) was more frequent in MMUDs (8% vs 0%, P < .01). There were no significant differences between donors in the incidences of acute graft-versus-host disease (GVHD; 20% vs 22% grade 2-4, respectively, P = .83), chronic extensive GVHD (3-year cumulative incidence [CI] 23% vs 24%, P = .56), or treatment-related mortality (1-year CI 27% vs 27%, P = .96). Furthermore, there was no difference in 3-year overall survival (OS; 53% vs 49%, P = .44). Mismatch occurred at the antigenic level in 40 cases. The outcome in these cases did not differ significantly from the rest of the cohort. We conclude that RIT using HLA-mismatched grafts is a viable option using FMC conditioning.

Authors+Show Affiliations

Department of Haematology, University College London (UCL) Medical School, London, United Kingdom.No 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 availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

20371745

Citation

Mead, Adam J., et al. "HLA-mismatched Unrelated Donors Are a Viable Alternate Graft Source for Allogeneic Transplantation Following Alemtuzumab-based Reduced-intensity Conditioning." Blood, vol. 115, no. 25, 2010, pp. 5147-53.
Mead AJ, Thomson KJ, Morris EC, et al. HLA-mismatched unrelated donors are a viable alternate graft source for allogeneic transplantation following alemtuzumab-based reduced-intensity conditioning. Blood. 2010;115(25):5147-53.
Mead, A. J., Thomson, K. J., Morris, E. C., Mohamedbhai, S., Denovan, S., Orti, G., Fielding, A. K., Kottaridis, P. D., Hough, R., Chakraverty, R., Linch, D. C., Mackinnon, S., & Peggs, K. S. (2010). HLA-mismatched unrelated donors are a viable alternate graft source for allogeneic transplantation following alemtuzumab-based reduced-intensity conditioning. Blood, 115(25), 5147-53. https://doi.org/10.1182/blood-2010-01-265413
Mead AJ, et al. HLA-mismatched Unrelated Donors Are a Viable Alternate Graft Source for Allogeneic Transplantation Following Alemtuzumab-based Reduced-intensity Conditioning. Blood. 2010 Jun 24;115(25):5147-53. PubMed PMID: 20371745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - HLA-mismatched unrelated donors are a viable alternate graft source for allogeneic transplantation following alemtuzumab-based reduced-intensity conditioning. AU - Mead,Adam J, AU - Thomson,Kirsty J, AU - Morris,Emma C, AU - Mohamedbhai,Sajir, AU - Denovan,Shari, AU - Orti,Guillermo, AU - Fielding,Adele K, AU - Kottaridis,Panagiotis D, AU - Hough,Rachael, AU - Chakraverty,Ronjon, AU - Linch,David C, AU - Mackinnon,Stephen, AU - Peggs,Karl S, Y1 - 2010/04/06/ PY - 2010/4/8/entrez PY - 2010/4/8/pubmed PY - 2010/7/10/medline SP - 5147 EP - 53 JF - Blood JO - Blood VL - 115 IS - 25 N2 - The impact of human leukocyte antigen (HLA) mismatch after reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation (RIT) using unrelated donors (UD) is unclear, and may be modulated by T-cell depletion. We therefore examined outcomes of 157 consecutive patients undergoing RIT after uniform conditioning with fludarabine, melphalan, and alemtuzumab (FMC). Donors were 10/10 HLA-matched (MUDs, n = 107) and 6 to 9/10 HLA-matched (MMUDs, n = 50), with no significant differences in baseline characteristics other than increased cytomegalovirus seropositivity in MMUDs. Rates of durable engraftment were high. Graft failure rates (persistent cytopenias with donor chimerism) were similar (8% vs 3%, P = .21), though rejection (recipient chimerism) was more frequent in MMUDs (8% vs 0%, P < .01). There were no significant differences between donors in the incidences of acute graft-versus-host disease (GVHD; 20% vs 22% grade 2-4, respectively, P = .83), chronic extensive GVHD (3-year cumulative incidence [CI] 23% vs 24%, P = .56), or treatment-related mortality (1-year CI 27% vs 27%, P = .96). Furthermore, there was no difference in 3-year overall survival (OS; 53% vs 49%, P = .44). Mismatch occurred at the antigenic level in 40 cases. The outcome in these cases did not differ significantly from the rest of the cohort. We conclude that RIT using HLA-mismatched grafts is a viable option using FMC conditioning. SN - 1528-0020 UR - https://www.unboundmedicine.com/medline/citation/20371745/HLA_mismatched_unrelated_donors_are_a_viable_alternate_graft_source_for_allogeneic_transplantation_following_alemtuzumab_based_reduced_intensity_conditioning_ L2 - https://linkinghub.elsevier.com/retrieve/pii/blood-2010-01-265413 DB - PRIME DP - Unbound Medicine ER -