Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival

Theo de Witte; Ronald Brand; Anja van Biezen; Ghulam Mufti; Tapani Ruutu; Juergen Finke; Peter von dem Borne; Antonin Vitek; Michel Delforge; Paolo Alessandrino; Nicolas Harlahakis; Nigel Russell; Roberto Martino; Leo Verdonck; Nicholas Kroeger; Dietger Niederwieser

doi:10.1111/j.1365-2141.2009.07809.x

Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival

Theo de Witte, Ronald Brand, Anja van Biezen, Ghulam Mufti, Tapani Ruutu, Juergen Finke, Peter von dem Borne, Antonin Vitek, Michel Delforge, Paolo Alessandrino, Nicolas Harlahakis, Nigel Russell, Roberto Martino, Leo Verdonck, Nicholas Kroeger, Dietger Niederwieser

Research output: Contribution to journal › Article › peer-review

53 Citations (Scopus)

Abstract

P>Allogeneic stem cell transplantation (alloSCT) for patients with refractory anaemia may result in a 50% event-free survival, but the high non-relapse mortality (NRM) precludes a general application of this therapeutic modality. This study evaluated the impact of various pre-transplant variables, including disease duration, intensity of the conditioning regimen, type of donor and year of transplantation on outcome. The study population consisted of 374 patients; 244 were transplanted from human leucocyte antigen (HLA)-identical siblings and 130 patients from matched unrelated donors. The median age was 39 years. One hundred and two patients were transplanted after reduced intensity conditioning (RIC). The overall 4-year survival was 52%. The 4-year survival of patients transplanted with HLA-identical sibling donors and matched unrelated donors was 52% and 50%, respectively. Multivariate analysis showed an improved survival (P = 0 center dot 05) and a lower NRM (P = 0 center dot 02) when the transplantation was performed in recent years. Increasing age, and disease duration of > 12 months were associated with inferior survival. RIC resulted in a similar survival despite an increased relapse risk (P = 0 center dot 02). This improved outcome permits alloSCT in patients older than 50 years of age, even with the use of matched unrelated donors. AlloSCT should be preferentially performed early after diagnosis after careful analysis of prognostic variables.

Original language	English
Pages (from-to)	627 - 636
Number of pages	10
Journal	British Journal of Haematology
Volume	146
Issue number	6
DOIs	https://doi.org/10.1111/j.1365-2141.2009.07809.x
Publication status	Published - Sept 2009

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de Witte, T., Brand, R., van Biezen, A., Mufti, G., Ruutu, T., Finke, J., von dem Borne, P., Vitek, A., Delforge, M., Alessandrino, P., Harlahakis, N., Russell, N., Martino, R., Verdonck, L., Kroeger, N., & Niederwieser, D. (2009). Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival. British Journal of Haematology, 146(6), 627 - 636. https://doi.org/10.1111/j.1365-2141.2009.07809.x

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title = "Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival",

abstract = "P>Allogeneic stem cell transplantation (alloSCT) for patients with refractory anaemia may result in a 50% event-free survival, but the high non-relapse mortality (NRM) precludes a general application of this therapeutic modality. This study evaluated the impact of various pre-transplant variables, including disease duration, intensity of the conditioning regimen, type of donor and year of transplantation on outcome. The study population consisted of 374 patients; 244 were transplanted from human leucocyte antigen (HLA)-identical siblings and 130 patients from matched unrelated donors. The median age was 39 years. One hundred and two patients were transplanted after reduced intensity conditioning (RIC). The overall 4-year survival was 52%. The 4-year survival of patients transplanted with HLA-identical sibling donors and matched unrelated donors was 52% and 50%, respectively. Multivariate analysis showed an improved survival (P = 0 center dot 05) and a lower NRM (P = 0 center dot 02) when the transplantation was performed in recent years. Increasing age, and disease duration of > 12 months were associated with inferior survival. RIC resulted in a similar survival despite an increased relapse risk (P = 0 center dot 02). This improved outcome permits alloSCT in patients older than 50 years of age, even with the use of matched unrelated donors. AlloSCT should be preferentially performed early after diagnosis after careful analysis of prognostic variables.",

author = "{de Witte}, Theo and Ronald Brand and {van Biezen}, Anja and Ghulam Mufti and Tapani Ruutu and Juergen Finke and {von dem Borne}, Peter and Antonin Vitek and Michel Delforge and Paolo Alessandrino and Nicolas Harlahakis and Nigel Russell and Roberto Martino and Leo Verdonck and Nicholas Kroeger and Dietger Niederwieser",

year = "2009",

month = sep,

doi = "10.1111/j.1365-2141.2009.07809.x",

language = "English",

volume = "146",

pages = "627 -- 636",

journal = "British Journal of Haematology",

issn = "1365-2141",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "6",

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de Witte, T, Brand, R, van Biezen, A, Mufti, G, Ruutu, T, Finke, J, von dem Borne, P, Vitek, A, Delforge, M, Alessandrino, P, Harlahakis, N, Russell, N, Martino, R, Verdonck, L, Kroeger, N & Niederwieser, D 2009, 'Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival', British Journal of Haematology, vol. 146, no. 6, pp. 627 - 636. https://doi.org/10.1111/j.1365-2141.2009.07809.x

Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival. / de Witte, Theo; Brand, Ronald; van Biezen, Anja et al.
In: British Journal of Haematology, Vol. 146, No. 6, 09.2009, p. 627 - 636.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival

AU - de Witte, Theo

AU - Brand, Ronald

AU - van Biezen, Anja

AU - Mufti, Ghulam

AU - Ruutu, Tapani

AU - Finke, Juergen

AU - von dem Borne, Peter

AU - Vitek, Antonin

AU - Delforge, Michel

AU - Alessandrino, Paolo

AU - Harlahakis, Nicolas

AU - Russell, Nigel

AU - Martino, Roberto

AU - Verdonck, Leo

AU - Kroeger, Nicholas

AU - Niederwieser, Dietger

PY - 2009/9

Y1 - 2009/9

N2 - P>Allogeneic stem cell transplantation (alloSCT) for patients with refractory anaemia may result in a 50% event-free survival, but the high non-relapse mortality (NRM) precludes a general application of this therapeutic modality. This study evaluated the impact of various pre-transplant variables, including disease duration, intensity of the conditioning regimen, type of donor and year of transplantation on outcome. The study population consisted of 374 patients; 244 were transplanted from human leucocyte antigen (HLA)-identical siblings and 130 patients from matched unrelated donors. The median age was 39 years. One hundred and two patients were transplanted after reduced intensity conditioning (RIC). The overall 4-year survival was 52%. The 4-year survival of patients transplanted with HLA-identical sibling donors and matched unrelated donors was 52% and 50%, respectively. Multivariate analysis showed an improved survival (P = 0 center dot 05) and a lower NRM (P = 0 center dot 02) when the transplantation was performed in recent years. Increasing age, and disease duration of > 12 months were associated with inferior survival. RIC resulted in a similar survival despite an increased relapse risk (P = 0 center dot 02). This improved outcome permits alloSCT in patients older than 50 years of age, even with the use of matched unrelated donors. AlloSCT should be preferentially performed early after diagnosis after careful analysis of prognostic variables.

AB - P>Allogeneic stem cell transplantation (alloSCT) for patients with refractory anaemia may result in a 50% event-free survival, but the high non-relapse mortality (NRM) precludes a general application of this therapeutic modality. This study evaluated the impact of various pre-transplant variables, including disease duration, intensity of the conditioning regimen, type of donor and year of transplantation on outcome. The study population consisted of 374 patients; 244 were transplanted from human leucocyte antigen (HLA)-identical siblings and 130 patients from matched unrelated donors. The median age was 39 years. One hundred and two patients were transplanted after reduced intensity conditioning (RIC). The overall 4-year survival was 52%. The 4-year survival of patients transplanted with HLA-identical sibling donors and matched unrelated donors was 52% and 50%, respectively. Multivariate analysis showed an improved survival (P = 0 center dot 05) and a lower NRM (P = 0 center dot 02) when the transplantation was performed in recent years. Increasing age, and disease duration of > 12 months were associated with inferior survival. RIC resulted in a similar survival despite an increased relapse risk (P = 0 center dot 02). This improved outcome permits alloSCT in patients older than 50 years of age, even with the use of matched unrelated donors. AlloSCT should be preferentially performed early after diagnosis after careful analysis of prognostic variables.

U2 - 10.1111/j.1365-2141.2009.07809.x

DO - 10.1111/j.1365-2141.2009.07809.x

M3 - Article

SN - 1365-2141

VL - 146

SP - 627

EP - 636

JO - British Journal of Haematology

JF - British Journal of Haematology

IS - 6

ER -

Allogeneic stem cell transplantation for patients with refractory anaemia with matched related and unrelated donors: delay of the transplant is associated with inferior survival

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