Peripheral Blood Stem Cell Transplantation from Human Leukocyte Antigen-Matched Sibling Donors and Unrelated Donors in Acute Myeloid Leukemia Patients

Abstract

There have been rare comparative studies of hematopoietic stem cell transplantation from matched sibling donors (MSDs) and unrelated donors (URDs) with regard to peripheral blood stem cell transplantation (PBSCT). We performed a retrospective study of 104 consecutive acute myeloid leukemia (AML) patients who had received an allogeneic PBSCT from an MSD or a URD in order to compare transplant outcomes and posttransplant complications between the 2 groups of patients. The cumulative incidence of grade 2-4 acute graft-versus-host disease (aGVHD) at 100 days (22.6% with MSD vs. 35.3% with URD; p = 0.107) and that of chronic GVHD (cGVHD) at 2 years (72.9% with MSD vs. 56.1% with URD; p = 0.153) was not significantly different between the 2 groups. Multivariate analysis also indicated that a URD was not an independent predictor of grade 2-4 aGVHD or cGVHD. No statistically significant differences were observed in terms of relapse incidence (p = 0.371), nonrelapse mortality (p = 0.473), disease-free survival (p = 0.925) or overall survival (p = 0.534) at 2 years. URDs are comparable with MSDs as a donor type for PBSCT in AML patients if risk-stratified GVHD prophylaxis is adopted.

Risk Factors for Graft-Versus-Host Disease After Transplantation of Hematopoietic Stem Cells from Unrelated Donors in the China Marrow Donor Program

“…The only difference was that rabbit ATG was used in some cases to remove T lymphocytes in the grafts. Here, the absence of ATG prophylaxis was associated with aGVHD, which is consistent with a previous study of HSCT from Korea [ 38 ], in which the incidence of grade II–IV aGVHD was reduced from 41.9% to 25.0% with ATG. In addition, ATG may reduce the incidence of moderate-to-high-grade/severe aGVHD [ 39 , 40 ] as well as increase the 6-year OS [ 41 ].…”

Adjuvant Peptide Pulsed Dendritic Cell Vaccination in Addition to T Cell Adoptive Immunotherapy for Cytomegalovirus Infection in Allogeneic Hematopoietic Stem Cell Transplantation Recipients

“…In a small study of this type, it is not possible to determine whether this represents an effect of the combined DC and T cell administration, particularly given the 58% incidence of grade II-IV acute GVHD and 56% incidence of chronic GVHD in allogeneic HSCT recipients at our institution [16]. This is in line with published figures from other centers [17,18]. A previous study demonstrated the safety of donor-derived CMV peptide-pulsed DC vaccination when used alone in 24 HSCT recipients [11].…”

Adoptable strategic approaches to improve outcomes of allogeneic peripheral blood stem cell transplantations from unrelated donors

“…The OS rate at 4 years was 58.2% versus 49.1%, and the cumulative incidence of relapse was 28.4% versus 25.0% for the related and unrelated PBSCT, respectively, representing no significance . Furthermore, according to recent Korean data on PBSCT, no significant differences have been observed in terms of the relapse incidence (p = 0.371), NRM (p = 0.473), disease‐free survival (DFS) (p = 0.925), or OS (p = 0.534) at 2 years between related and unrelated PBSCT.…”