Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Allografting

Donor age and degree of HLA matching have a major impact on the outcome of unrelated donor haematopoietic cell transplantation for chronic myeloid leukaemia

Bone Marrow Transplantation volume 37, pages 33–40 (2006)Cite this article

Abstract

We analysed the outcome of 92 consecutive unrelated donor haematopoietic cell transplantations (UD-HCTs) performed in Spain to treat adult patients with CML in the first chronic phase (1CP). Patients' and donors' median age was 32 (15–49) and 36 (22–56) years, respectively. In all, 73 pairs (79%) matched for A, B±C and DRB1±DQB1 loci and 19 had ⩾1 mismatch. Their probability of survival and disease-free survival at 4 years were 50 and 46%, respectively. Pretransplant factors associated with a better survival were patient age <25 years (P=0.035), donor age ⩽36 years (P=0.012), use of cyclosporine since day –7 (P=0.001), and matching 8/8, 9/10 or 10/10 loci at allele level (P=0.003). In multivariate analysis only donor age (P=0.003; RR=3.1 (95% CI: 1.3–7.1)) and degree of HLA-matching (P=0.009; RR: 7.7 (95% CI: 1.8–33)) maintained their significance. The addition of these two variables to the EBMT prognostic score allowed an adequate risk assessment for patients receiving a UD-HCT during 1CP. Our analysis shows that in patients with a young and fully allele-matched donor, UD-HCT should be considered in the initial therapeutic algorithm due to its excellent outcome (92% survival at 2 years).

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Hughes TP, Kaeda J, Branford S, Rudzki Z, Hochhaus A, Hensley ML et al. International Randomised Study of Interferon versus STI571 (IRIS) Study Group. Frequency of major molecular responses to imatinib or interferon alfa plus cytarabine in newly diagnosed chronic myeloid leukemia. N Engl J Med 2003; 349: 1423–1432.

    Article  CAS  PubMed  Google Scholar 

  2. Radich JP, Olavarria E, Apperley JF . Allogeneic hematopoietic haematopoietic cell transplantation for chronic myeloid leukemia. Hematol Oncol Clin North Am 2004; 18: 685–702.

    Article  PubMed  Google Scholar 

  3. Appelbaum FR . Allogeneic transplantation for chronic myeloid leukemia. In: Blume KG, Forman SJ, Appelbaum F (eds). Thomas' Hematopoietic Cell Transplantation. Blackwell Publishing: Maiden (MA), 2004, pp 1007–1017.

    Google Scholar 

  4. Anasetti C . Advances in unrelated donor hematopoietic cell transplantation. Haematologica 2003; 88: 246–249.

    PubMed  Google Scholar 

  5. Bone Marrow Donor Wordwide webpage. http://www.bmdw.org.

  6. REDMO webpage. https://www.fcarreras.org.

  7. Tiercy JM, Bujan-Lose M, Chapuis B, Gratwohl A, Gmur J, Seger R et al. Bone marrow transplantation with unrelated donors: what is the probability of identifying an HLAA/B/Cw/DRB1/B3/B5/DQB1 – matched donor? Bone Marrow Transplant 2000; 26: 437–441.

    Article  CAS  PubMed  Google Scholar 

  8. Carreras E, Tomas JF, Sanz G, Iriondo A, Boqué C, López J et al. Unrelated donor bone marrow transplantation as treatment for chronic myeloid leukemia: the Spanish experience. The Chronic Myeloid Leukemia Subcommittee of the GETH. Grupo Espanol de Trasplante Hemopoyetico. Haematologica 2000; 85: 530–538.

    CAS  PubMed  Google Scholar 

  9. Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors. Transplantation 1974; 18: 295–304.

    Article  CAS  PubMed  Google Scholar 

  10. Shulman HM, Sullivan KM, Weiden PL, McDOnald GB, Striker GE, Sale GE et al. Chronic graft-versus-host syndrome in man. A long-term clinico-pathological study of 20 Seattle patients. Am J Med 1980; 69: 204–217.

    Article  CAS  PubMed  Google Scholar 

  11. Kaplan EL, Meier P . Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457–481.

    Article  Google Scholar 

  12. Grey RJ . A case of K-sample test for comparing the cumulative incidence of a competing risk. Ann Statist 1988; 16: 1141–1154.

    Article  Google Scholar 

  13. Cox DR . Regression models and life-tables. J R Stat Soc [B] 1972; 34: 187–220.

    Google Scholar 

  14. Gratwohl A, Hermans J, Goldman JM, Arcese W, Carreras E, Devergie A et al. Risk assessment for patients with chronic myeloid leukaemia before allogeneic blood or marrow transplantation. Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Lancet 1998; 352: 1087–1092.

    Article  CAS  PubMed  Google Scholar 

  15. Lamparelli T, van Lint MT, Gualandi F, Occhini D, Barbanti M, Sacchi N et al. Bone marrow transplantation for chronic myeloid leukemia from unrelated and sibling donors: single center experience. Bone Marrow Transplant 1997; 20: 1057–1062.

    Article  CAS  PubMed  Google Scholar 

  16. Elmaagacli AH, Basoglu S, Peceny R, Trenschel R, Ottinger H, Lollert A et al. Improved disease-free-survival after transplantation of peripheral blood haematopoietic cells as compared with bone marrow from HLA-identical unrelated donors in patients with first chronic phase chronic myeloid leukemia. Blood 2002; 99: 1130–1135.

    CAS  PubMed  Google Scholar 

  17. Tiercy JM, Passweg J, van Biezen A, Zander A, Kroger N, Gratwohl A et al. Chronic Leukemia Working Party of the European Blood and Marrow Transplant Group (EBMT). Isolated HLA-C mismatches in unrelated donor transplantation for CML. Bone Marrow Transplant 2004; 34: 249–255.

    Article  CAS  PubMed  Google Scholar 

  18. Flomenberg N, Baxter-Lowe LA, Confer D, Fernandez-Viñas M, Filipovich A, Horowitz M et al. Impact of HLA-class I and class II high resolution matching on outcomes of unrelated donor BMT: HLA-C mismatching is associated with a strong adverse effect on transplant outcome. Blood 2004; 104: 1923–1930.

    Article  CAS  PubMed  Google Scholar 

  19. Petersdorf EW, Anasetti C, Martin PJ, Gooley T, Radich J, Malkki M et al. Limits of HLA mismatching in unrelated hematopoietic cell transplantation. Blood 2004; 104: 2976–2980.

    Article  CAS  PubMed  Google Scholar 

  20. Kollman C, Howe CW, Anasetti C, Antin JH, Davies SM, Filipovich AH et al. Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age. Blood 2001; 98: 2043–2051.

    Article  CAS  PubMed  Google Scholar 

  21. Bowden RA, Sayers M, Flournoy N, Newton B, Benaji M, Thomas EFD et al. Cytomegalovirus immune globulin and seronegative blood products to prevent primary cytomegalovirus infection after marrow transplantation. N Engl J Med 1986; 314: 1006–1010.

    Article  CAS  PubMed  Google Scholar 

  22. Ljungman P, Brand R, Einsele H, Frassoni F, Niederwieser D, Cordonnier C . Donor CMV serologic status and outcome of CMV-seropositive recipients after unrelated donor stem cell transplantation: an EBMT megafile analysis. Blood 2003; 102: 4255–4260.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge the support received from Clara Pérez and Cristina Fusté, members of the REDMO. We thank Professor Ciril Rozman for his comments on the preparation of the manuscript.

Author information

Authors and Affiliations

  1. Spanish Bone Marrow Donor Registry (REDMO), IDIBAPS, Barcelona, Spain

    E Carreras

  2. Hospital Clínic, IDIBAPS, Barcelona, Spain

    E Carreras, M Jiménez, C Martínez & M Rovira

  3. Hospital de la Princesa, Madrid, Spain

    V Gómez-García, R de la Cámara & J M Fernández-Rañada

  4. Hospital Reina Sofía, Córdoba, Spain

    C Martín, F Martínez & A Torres

  5. Hospital Marqués de Valdecilla, Santander, Spain

    A Iriondo

  6. Hospital la Fe, Valencia, Spain

    G Sanz

  7. Hospital Universitario, Salamanca, Spain

    C Cañizo

  8. Clínica Puerta de Hierro, Madrid, Spain

    R Cabrera

  9. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    J Sierra

  10. Hospital Universitario, Murcia, Spain

    C Vallejo

  11. Hospital Ramón y Cajal, Madrid, Spain

    J López

Authors
  1. E Carreras
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Jiménez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V Gómez-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R de la Cámara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C Martín
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A Iriondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G Sanz
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C Cañizo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. R Cabrera
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. J Sierra
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. C Vallejo
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. J López
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. C Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. M Rovira
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. J M Fernández-Rañada
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. A Torres
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

on behalf of the Chronic Myeloid Leukaemia Subcommittee of the GETH (Grupo Español de Trasplante Hemopoyético)

Corresponding author

Correspondence to E Carreras.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carreras, E., Jiménez, M., Gómez-García, V. et al. Donor age and degree of HLA matching have a major impact on the outcome of unrelated donor haematopoietic cell transplantation for chronic myeloid leukaemia. Bone Marrow Transplant 37, 33–40 (2006). https://doi.org/10.1038/sj.bmt.1705195

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1705195

Keywords

This article is cited by

Search

Advanced search

Quick links