Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings

R. Szydlo, J. M. Goldman, J. P. Klein, R. P. Gale, R. C. Ash, F. H. Bach, B. A. Bradley, J. T. Casper, N. Flomenberg, J. L. Gajewski, E. Gluckman, P. J. Henslee-Downey, J. M. Hows, N. Jacobsen, H. J. Kolb, B. Lowenberg, T. Masaoka, P. A. Rowlings, P. M. Sondel, D. W. van BekkumJ. J. van Rood, M. R. Vowels, M. J. Zhang, M. M. Horowitz

Research output: Contribution to journalArticle

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Abstract

Purpose: To compare outcomes of bone marrow transplants for leukemia from HLA-identical siblings, haploidentical HLA-mismatched relatives, and HLA-matched and mismatched unrelated donors. Patients: A total of 2,055 recipients of allogeneic bone marrow transplants for chronic myelogenous leukemia (CML), acute myelogenous leukemia (AML), and acute lymphoblastic leukemia (ALL) were entered onto the study. Transplants were performed between 1985 and 1991 and reported to the international Bone Marrow Transplant Registry (IBMTR). Donors were HLA-identical siblings (n = 1,224); haploidentical relatives mismatched for one (n = 238) or two (n = 102) HLA- A, -B, or -DR antigens; or unrelated persons who were HLA-matched (n = 383) or mismatched for one HLA-A, -B, or -DR antigen (n = 108). HLA typing was performed using serologic techniques. Results: Transplant-related mortality was significantly higher after alternative donor transplants than after HLA- identical sibling transplants. Among patients with early leukemia (CML in chronic phase or acute leukemia in first remission), 3-year transplant- elated mortality (± SE) was 21% ± 2% after HLA-identical sibling transplants and greater than 50% after all types of alternative donor transplants studied. Among patients with early leukemia, relative risks of treatment failure (inverse of leukemia-free survival), using HLA-identical sibling transplants as the reference group, were 2.43 (P <.0001) with 1- HLA-antigen-mismatched related donors, 3.79 (P <.0001) with 2-HLA-antigen- mismatched related donors, 2.11 (P <.0001) with HLA-matched unrelated donors, and 3.33 (P <.0001) with 1-HLA-antigen-mismatched unrelated donors. For patients with more advanced leukemia, differences in treatment failure were less striking: 1-HLA-antigen-mismatched relatives, 1.22 (P = not significant [NS]); 2-HLA-antigen- mismatched relatives, 1.81 (P

Original languageEnglish (US)
Pages (from-to)1767-1777
Number of pages11
JournalJournal of Clinical Oncology
Volume15
Issue number5
StatePublished - May 1997
Externally publishedYes

Fingerprint

Siblings
Leukemia
Bone Marrow
Tissue Donors
Transplants
HLA Antigens
Unrelated Donors
HLA-A Antigens
HLA-B Antigens
Treatment Failure
Leukemia, Myeloid, Chronic Phase
Antigens
Histocompatibility Testing
Mortality
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia
Registries
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Szydlo, R., Goldman, J. M., Klein, J. P., Gale, R. P., Ash, R. C., Bach, F. H., ... Horowitz, M. M. (1997). Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings. Journal of Clinical Oncology, 15(5), 1767-1777.

Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings. / Szydlo, R.; Goldman, J. M.; Klein, J. P.; Gale, R. P.; Ash, R. C.; Bach, F. H.; Bradley, B. A.; Casper, J. T.; Flomenberg, N.; Gajewski, J. L.; Gluckman, E.; Henslee-Downey, P. J.; Hows, J. M.; Jacobsen, N.; Kolb, H. J.; Lowenberg, B.; Masaoka, T.; Rowlings, P. A.; Sondel, P. M.; van Bekkum, D. W.; van Rood, J. J.; Vowels, M. R.; Zhang, M. J.; Horowitz, M. M.

In: Journal of Clinical Oncology, Vol. 15, No. 5, 05.1997, p. 1767-1777.

Research output: Contribution to journalArticle

Szydlo, R, Goldman, JM, Klein, JP, Gale, RP, Ash, RC, Bach, FH, Bradley, BA, Casper, JT, Flomenberg, N, Gajewski, JL, Gluckman, E, Henslee-Downey, PJ, Hows, JM, Jacobsen, N, Kolb, HJ, Lowenberg, B, Masaoka, T, Rowlings, PA, Sondel, PM, van Bekkum, DW, van Rood, JJ, Vowels, MR, Zhang, MJ & Horowitz, MM 1997, 'Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings', Journal of Clinical Oncology, vol. 15, no. 5, pp. 1767-1777.
Szydlo R, Goldman JM, Klein JP, Gale RP, Ash RC, Bach FH et al. Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings. Journal of Clinical Oncology. 1997 May;15(5):1767-1777.
Szydlo, R. ; Goldman, J. M. ; Klein, J. P. ; Gale, R. P. ; Ash, R. C. ; Bach, F. H. ; Bradley, B. A. ; Casper, J. T. ; Flomenberg, N. ; Gajewski, J. L. ; Gluckman, E. ; Henslee-Downey, P. J. ; Hows, J. M. ; Jacobsen, N. ; Kolb, H. J. ; Lowenberg, B. ; Masaoka, T. ; Rowlings, P. A. ; Sondel, P. M. ; van Bekkum, D. W. ; van Rood, J. J. ; Vowels, M. R. ; Zhang, M. J. ; Horowitz, M. M. / Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings. In: Journal of Clinical Oncology. 1997 ; Vol. 15, No. 5. pp. 1767-1777.
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abstract = "Purpose: To compare outcomes of bone marrow transplants for leukemia from HLA-identical siblings, haploidentical HLA-mismatched relatives, and HLA-matched and mismatched unrelated donors. Patients: A total of 2,055 recipients of allogeneic bone marrow transplants for chronic myelogenous leukemia (CML), acute myelogenous leukemia (AML), and acute lymphoblastic leukemia (ALL) were entered onto the study. Transplants were performed between 1985 and 1991 and reported to the international Bone Marrow Transplant Registry (IBMTR). Donors were HLA-identical siblings (n = 1,224); haploidentical relatives mismatched for one (n = 238) or two (n = 102) HLA- A, -B, or -DR antigens; or unrelated persons who were HLA-matched (n = 383) or mismatched for one HLA-A, -B, or -DR antigen (n = 108). HLA typing was performed using serologic techniques. Results: Transplant-related mortality was significantly higher after alternative donor transplants than after HLA- identical sibling transplants. Among patients with early leukemia (CML in chronic phase or acute leukemia in first remission), 3-year transplant- elated mortality (± SE) was 21{\%} ± 2{\%} after HLA-identical sibling transplants and greater than 50{\%} after all types of alternative donor transplants studied. Among patients with early leukemia, relative risks of treatment failure (inverse of leukemia-free survival), using HLA-identical sibling transplants as the reference group, were 2.43 (P <.0001) with 1- HLA-antigen-mismatched related donors, 3.79 (P <.0001) with 2-HLA-antigen- mismatched related donors, 2.11 (P <.0001) with HLA-matched unrelated donors, and 3.33 (P <.0001) with 1-HLA-antigen-mismatched unrelated donors. For patients with more advanced leukemia, differences in treatment failure were less striking: 1-HLA-antigen-mismatched relatives, 1.22 (P = not significant [NS]); 2-HLA-antigen- mismatched relatives, 1.81 (P",
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T1 - Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings

AU - Szydlo, R.

AU - Goldman, J. M.

AU - Klein, J. P.

AU - Gale, R. P.

AU - Ash, R. C.

AU - Bach, F. H.

AU - Bradley, B. A.

AU - Casper, J. T.

AU - Flomenberg, N.

AU - Gajewski, J. L.

AU - Gluckman, E.

AU - Henslee-Downey, P. J.

AU - Hows, J. M.

AU - Jacobsen, N.

AU - Kolb, H. J.

AU - Lowenberg, B.

AU - Masaoka, T.

AU - Rowlings, P. A.

AU - Sondel, P. M.

AU - van Bekkum, D. W.

AU - van Rood, J. J.

AU - Vowels, M. R.

AU - Zhang, M. J.

AU - Horowitz, M. M.

PY - 1997/5

Y1 - 1997/5

N2 - Purpose: To compare outcomes of bone marrow transplants for leukemia from HLA-identical siblings, haploidentical HLA-mismatched relatives, and HLA-matched and mismatched unrelated donors. Patients: A total of 2,055 recipients of allogeneic bone marrow transplants for chronic myelogenous leukemia (CML), acute myelogenous leukemia (AML), and acute lymphoblastic leukemia (ALL) were entered onto the study. Transplants were performed between 1985 and 1991 and reported to the international Bone Marrow Transplant Registry (IBMTR). Donors were HLA-identical siblings (n = 1,224); haploidentical relatives mismatched for one (n = 238) or two (n = 102) HLA- A, -B, or -DR antigens; or unrelated persons who were HLA-matched (n = 383) or mismatched for one HLA-A, -B, or -DR antigen (n = 108). HLA typing was performed using serologic techniques. Results: Transplant-related mortality was significantly higher after alternative donor transplants than after HLA- identical sibling transplants. Among patients with early leukemia (CML in chronic phase or acute leukemia in first remission), 3-year transplant- elated mortality (± SE) was 21% ± 2% after HLA-identical sibling transplants and greater than 50% after all types of alternative donor transplants studied. Among patients with early leukemia, relative risks of treatment failure (inverse of leukemia-free survival), using HLA-identical sibling transplants as the reference group, were 2.43 (P <.0001) with 1- HLA-antigen-mismatched related donors, 3.79 (P <.0001) with 2-HLA-antigen- mismatched related donors, 2.11 (P <.0001) with HLA-matched unrelated donors, and 3.33 (P <.0001) with 1-HLA-antigen-mismatched unrelated donors. For patients with more advanced leukemia, differences in treatment failure were less striking: 1-HLA-antigen-mismatched relatives, 1.22 (P = not significant [NS]); 2-HLA-antigen- mismatched relatives, 1.81 (P

AB - Purpose: To compare outcomes of bone marrow transplants for leukemia from HLA-identical siblings, haploidentical HLA-mismatched relatives, and HLA-matched and mismatched unrelated donors. Patients: A total of 2,055 recipients of allogeneic bone marrow transplants for chronic myelogenous leukemia (CML), acute myelogenous leukemia (AML), and acute lymphoblastic leukemia (ALL) were entered onto the study. Transplants were performed between 1985 and 1991 and reported to the international Bone Marrow Transplant Registry (IBMTR). Donors were HLA-identical siblings (n = 1,224); haploidentical relatives mismatched for one (n = 238) or two (n = 102) HLA- A, -B, or -DR antigens; or unrelated persons who were HLA-matched (n = 383) or mismatched for one HLA-A, -B, or -DR antigen (n = 108). HLA typing was performed using serologic techniques. Results: Transplant-related mortality was significantly higher after alternative donor transplants than after HLA- identical sibling transplants. Among patients with early leukemia (CML in chronic phase or acute leukemia in first remission), 3-year transplant- elated mortality (± SE) was 21% ± 2% after HLA-identical sibling transplants and greater than 50% after all types of alternative donor transplants studied. Among patients with early leukemia, relative risks of treatment failure (inverse of leukemia-free survival), using HLA-identical sibling transplants as the reference group, were 2.43 (P <.0001) with 1- HLA-antigen-mismatched related donors, 3.79 (P <.0001) with 2-HLA-antigen- mismatched related donors, 2.11 (P <.0001) with HLA-matched unrelated donors, and 3.33 (P <.0001) with 1-HLA-antigen-mismatched unrelated donors. For patients with more advanced leukemia, differences in treatment failure were less striking: 1-HLA-antigen-mismatched relatives, 1.22 (P = not significant [NS]); 2-HLA-antigen- mismatched relatives, 1.81 (P

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