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Prognostic Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Adults with Chronic Myelomonocytic Leukemia: A Nationwide Retrospective Analysis in Japan
- Source :
- Biology of Blood and Marrow Transplantation. 24:840-848
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapeutic option for patients with chronic myelomonocytic leukemia (CMML). We retrospectively compared the post-transplantation outcomes of 159 patients with CMML who underwent allo-HSCT using 4 types of donor sources: HLA-matched related donor graft, unrelated bone marrow (U-BM), unrelated cord blood (U-CB), and HLA-mismatched related donor graft. The median patient age at allo-HSCT was 54 years (range, 16 to 75 years). In multivariate analyses, the use of HLA-matched related donor grafts correlated with better overall survival than U-BM (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.21 to 3.48; P = .008), U-CB (HR, 3.80; 95% CI, 2.07 to 6.95; P .001), or HLA-mismatched related donor grafts (HR, 6.18; 95% CI, 2.70 to 14.15; P .001). Mortality after the relapse or progression of CMML did not significantly differ among the 4 types of donor source. Transplantation-related mortality was highest in recipients of U-CB (HR, 3.32; 95% CI, 1.33 to 8.26; P = .010). In patients with CMML, allo-HSCT using an alternative donor may contribute to durable remission; however, further improvements in transplantation-related mortality are required for this type of transplantation.
- Subjects :
- Adult
Male
Oncology
medicine.medical_specialty
Multivariate analysis
Adolescent
medicine.medical_treatment
Chronic myelomonocytic leukemia
Hematopoietic stem cell transplantation
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Japan
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
hemic and lymphatic diseases
Internal medicine
medicine
Retrospective analysis
Humans
Aged
Retrospective Studies
Transplantation
business.industry
Hazard ratio
Age Factors
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
Allografts
medicine.disease
Confidence interval
Survival Rate
surgical procedures, operative
medicine.anatomical_structure
030220 oncology & carcinogenesis
Cord blood
Immunology
Female
Bone marrow
business
030215 immunology
Subjects
Details
- ISSN :
- 10838791
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Biology of Blood and Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....766a9ba4363c2037858e2cbfa0d2a36b