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[Impact of HLA compatibility on the outcome of allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia].
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Mar; 31(3):438-42.NF

Abstract

OBJECTIVE

To analyze the influence of HLA compatibility on the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with chronic myeloid leukemia (CML).

METHODS

This retrospective study involved 121 CML patients including 90 in chronic phase, 8 in accelerated phase and 23 with blast crisis. Of these patients, 85 received related and 36 had unrelated donor allo-HSCT. The conditioning regimens included total body irradiation with cyclophosphamide in 37 patients, and modified BUCY protocol in 84 patients. Cyclosporine A (CsA) and methotrexate (MTX) were used for graft-versus-host disease (GVHD) prophylaxis in patients undergoing HLA-matched sibling donor transplants. CsA, MTX, antihuman thymocyte globulin and mycophenolate were used in all the patients undergoing HLA-mismatched related donor and unrelated donor transplants. The prognostic factors of CML were evaluated using Cox regression and the cumulative overall survival and the disease-free survival were estimated using Kaplan and Meier survival analysis model.

RESULTS

The incidence of II-IV acute GVHD was 26.1% in HLA-matched and 53.3% in HLA-mismatched cases (P=0.006), with a 5-year cumulative incidence of chronic GVHD of 47.4% and 49.6%, respectively (P=0.947). The 5-year cumulative incidences of disease relapse was 16.7% in the total patients, with a 5-year cumulative overall survival (OS) of 70.5% and disease-free survival (DFS) of 63.4%. The 5-year OS was 78.2% in HLA-matched cases, as compared with 47.6% in HLA-mismatched cases. Multivariate analysis with Cox regression model identified HLA mismatch, II-IV acute GVHD, and advanced phase as the risk factors affecting the OS.

CONCLUSION

HLA mismatch can significantly increase the incidence of II-IV acute GVHD following allo-HSCT and decrease the long-term survival rate, which is not related to the donor source.

Authors+Show Affiliations

Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. scidzy@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

chi

PubMed ID

21421478

Citation

ZHANG, Yu, et al. "[Impact of HLA Compatibility On the Outcome of Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myeloid Leukemia]." Nan Fang Yi Ke Da Xue Xue Bao = Journal of Southern Medical University, vol. 31, no. 3, 2011, pp. 438-42.
ZHANG Y, CHEN YK, FAN ZP, et al. [Impact of HLA compatibility on the outcome of allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia]. Nan Fang Yi Ke Da Xue Xue Bao. 2011;31(3):438-42.
ZHANG, Y., CHEN, Y. K., FAN, Z. P., XU, D., JIANG, Q. L., SUN, J., & LIU, Q. F. (2011). [Impact of HLA compatibility on the outcome of allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia]. Nan Fang Yi Ke Da Xue Xue Bao = Journal of Southern Medical University, 31(3), 438-42.
ZHANG Y, et al. [Impact of HLA Compatibility On the Outcome of Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myeloid Leukemia]. Nan Fang Yi Ke Da Xue Xue Bao. 2011;31(3):438-42. PubMed PMID: 21421478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Impact of HLA compatibility on the outcome of allogeneic hematopoietic stem cell transplantation for chronic myeloid leukemia]. AU - ZHANG,Yu, AU - CHEN,Yin-kui, AU - FAN,Zhi-ping, AU - XU,Dan, AU - JIANG,Qian-li, AU - SUN,Jing, AU - LIU,Qi-fa, PY - 2011/3/23/entrez PY - 2011/3/23/pubmed PY - 2013/3/6/medline SP - 438 EP - 42 JF - Nan fang yi ke da xue xue bao = Journal of Southern Medical University JO - Nan Fang Yi Ke Da Xue Xue Bao VL - 31 IS - 3 N2 - OBJECTIVE: To analyze the influence of HLA compatibility on the outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with chronic myeloid leukemia (CML). METHODS: This retrospective study involved 121 CML patients including 90 in chronic phase, 8 in accelerated phase and 23 with blast crisis. Of these patients, 85 received related and 36 had unrelated donor allo-HSCT. The conditioning regimens included total body irradiation with cyclophosphamide in 37 patients, and modified BUCY protocol in 84 patients. Cyclosporine A (CsA) and methotrexate (MTX) were used for graft-versus-host disease (GVHD) prophylaxis in patients undergoing HLA-matched sibling donor transplants. CsA, MTX, antihuman thymocyte globulin and mycophenolate were used in all the patients undergoing HLA-mismatched related donor and unrelated donor transplants. The prognostic factors of CML were evaluated using Cox regression and the cumulative overall survival and the disease-free survival were estimated using Kaplan and Meier survival analysis model. RESULTS: The incidence of II-IV acute GVHD was 26.1% in HLA-matched and 53.3% in HLA-mismatched cases (P=0.006), with a 5-year cumulative incidence of chronic GVHD of 47.4% and 49.6%, respectively (P=0.947). The 5-year cumulative incidences of disease relapse was 16.7% in the total patients, with a 5-year cumulative overall survival (OS) of 70.5% and disease-free survival (DFS) of 63.4%. The 5-year OS was 78.2% in HLA-matched cases, as compared with 47.6% in HLA-mismatched cases. Multivariate analysis with Cox regression model identified HLA mismatch, II-IV acute GVHD, and advanced phase as the risk factors affecting the OS. CONCLUSION: HLA mismatch can significantly increase the incidence of II-IV acute GVHD following allo-HSCT and decrease the long-term survival rate, which is not related to the donor source. SN - 1673-4254 UR - https://www.unboundmedicine.com/medline/citation/21421478/[Impact_of_HLA_compatibility_on_the_outcome_of_allogeneic_hematopoietic_stem_cell_transplantation_for_chronic_myeloid_leukemia]_ L2 - http://www.diseaseinfosearch.org/result/1622 DB - PRIME DP - Unbound Medicine ER -