Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age, and use of unrelated donors.

Theresa Hahn, Philip L. McCarthy, Anna Hassebroek, Christopher Bredeson, James L. Gajewski, Gregory A. Hale, Luis M. Isola, Hillard M. Lazarus, Stephanie J. Lee, Charles F. Lemaistre, Fausto Loberiza, Richard Maziarz, J. Douglas Rizzo, Steven Joffe, Susan Parsons, Navneet S. Majhail

Research output: Contribution to journalArticle

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Abstract

Over the past four decades, allogeneic hematopoietic cell transplantation (alloHCT) has evolved as a curative modality for patients with hematologic diseases. This study describes changes in use, technique, and survival in a population-based cohort. The study included 38,060 patients with hematologic malignancies or disorders who underwent first alloHCT in a US or Canadian center from 1994 to 2005 and were reported to the Center for International Blood and Marrow Transplant Research. AlloHCT as treatment for acute lymphoblastic (ALL) and myeloid leukemias (AML), myelodysplastic syndrome (MDS), and Hodgkin and non-Hodgkin lymphomas increased by 45%, from 2,520 to 3,668 patients annually. From 1994 to 2005, use of both peripheral (7% to 6%) and cord blood increased (2% to 10%), whereas use of marrow decreased (90% to 27%). Despite a median age increase from 33 to 40 years and % increase in unrelated donors for alloHCT, overall survival (OS) at day 100 significantly improved for patients with AML in first complete remission after myeloablative sibling alloHCT (85% to 94%; P <.001) and unrelated alloHCT (63% to 86%; P <.001); 1-year OS improved among those undergoing unrelated alloHCT (48% to 63%; P = .003) but not among those undergoing sibling alloHCT. Similar results were seen for ALL and MDS. Day-100 OS after cord blood alloHCT improved significantly from 60% to 78% (P <.001) for AML, ALL, MDS, and chronic myeloid leukemia. Use of reduced-intensity regimens increased, yielding OS rates similar to those of myeloablative regimens. Survival for those undergoing alloHCT has significantly improved over time. However, new approaches are needed to further improve 1-year OS.

Original languageEnglish (US)
Pages (from-to)2437-2449
Number of pages13
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Volume31
Issue number19
DOIs
StatePublished - Jul 1 2013

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Unrelated Donors
Cell Transplantation
Survival
Myelodysplastic Syndromes
Fetal Blood
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia
Siblings
Bone Marrow
Myeloid Leukemia
Hematologic Diseases
Hematologic Neoplasms
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Hodgkin Disease
Non-Hodgkin's Lymphoma
Survival Rate
Transplants

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age, and use of unrelated donors. / Hahn, Theresa; McCarthy, Philip L.; Hassebroek, Anna; Bredeson, Christopher; Gajewski, James L.; Hale, Gregory A.; Isola, Luis M.; Lazarus, Hillard M.; Lee, Stephanie J.; Lemaistre, Charles F.; Loberiza, Fausto; Maziarz, Richard; Rizzo, J. Douglas; Joffe, Steven; Parsons, Susan; Majhail, Navneet S.

In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Vol. 31, No. 19, 01.07.2013, p. 2437-2449.

Research output: Contribution to journalArticle

Hahn, T, McCarthy, PL, Hassebroek, A, Bredeson, C, Gajewski, JL, Hale, GA, Isola, LM, Lazarus, HM, Lee, SJ, Lemaistre, CF, Loberiza, F, Maziarz, R, Rizzo, JD, Joffe, S, Parsons, S & Majhail, NS 2013, 'Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age, and use of unrelated donors.', Journal of clinical oncology : official journal of the American Society of Clinical Oncology, vol. 31, no. 19, pp. 2437-2449. https://doi.org/10.1200/JCO.2012.46.6193
Hahn, Theresa ; McCarthy, Philip L. ; Hassebroek, Anna ; Bredeson, Christopher ; Gajewski, James L. ; Hale, Gregory A. ; Isola, Luis M. ; Lazarus, Hillard M. ; Lee, Stephanie J. ; Lemaistre, Charles F. ; Loberiza, Fausto ; Maziarz, Richard ; Rizzo, J. Douglas ; Joffe, Steven ; Parsons, Susan ; Majhail, Navneet S. / Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age, and use of unrelated donors. In: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013 ; Vol. 31, No. 19. pp. 2437-2449.
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