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Matched-Pair Analysis of Transplant from Haploidentical, Unmanipulated Bone Marrow Donor versus HLA Identical Sibling for Patients with Hematologic Malignancies.
Biology of Blood and Marrow Transplantation ( IF 5.609 ) Pub Date : 2020-02-14 , DOI: 10.1016/j.bbmt.2020.02.005
William Arcese 1 , Raffaella Cerretti 1 , Loredana Sarmati 2 , Laura Cudillo 1 , Gottardo De Angelis 1 , Benedetta Mariotti 1 , Antoine Bruno 1 , Ilaria Mangione 1 , Cristina Rapanotti 1 , Marco Andreani 3 , Paolo De Fabritiis 4 , Teresa Dentamaro 4 , Luca Cupelli 4 , Andrea Mengarelli 5 , Francesco Marchesi 5 , Maria Cristina Tirindelli 6 , Ombretta Annibali 6 , Agostino Tafuri 7 , Antonella Ferrari 7 , Michele Cedrone 8 , Barbara Anaclerico 8 , Gaspare Adorno 9 , Silvia Miccichè 1 , Massimo Andreoni 2 , Alessandra Picardi 1 ,
Affiliation  

A matched-pair analysis of transplant-related outcomes was carried out in 116 of 255 consecutive patients transplanted from HLA identical sibling (n=58) or haploidentical related donor (n=58). The two patient series were matched with 9 variables: period of transplant, patient and donor age, gender, diagnosis, disease phase, conditioning regimen, donor/recipient sex and CMV status combinations. As graft-versus-host disease prophylaxis, all patients received the standard cyclosporine and methotrexate association with the addition of anti-thymocyte globulins, mycophenolate-mofetil and Basiliximab in haploidentical, unmanipulated bone marrow recipients. Anti-infectious management, transfusion policy and supportive care were identical for all patients. By comparing the two patient series, no statistically significant difference was observed for the cumulative incidence of advanced acute and extensive chronic GVHD, TRM and relapse. With a median follow-up of 3.5 years, the 5-year DFS was 37±6% and 36±6% for HLA Id-sib and haplo recipients, respectively. The results of transplant from HLA id-siblings and haploidentical donors are comparable. Regardless of the HLA matching, other factors known to affect the transplant outcomes such as donor-recipient age, sex and CMV status combinations might drive the search for the best donor.

中文翻译:

血液恶性肿瘤患者单侧,未操作的骨髓供体与HLA同胞的移植的配对分析。

在从HLA同胞(n = 58)或单倍体相关供体(n = 58)移植的255例连续患者中,对116例移植相关结果进行了配对分析。这两个患者系列均匹配9个变量:移植时间,患者和供体年龄,性别,诊断,疾病阶段,适应方案,供体/接受者性别和CMV状态组合。作为预防移植物抗宿主病的方法,所有患者均接受标准的环孢素和甲氨蝶呤治疗,并在单倍体,未经操作的骨髓接受者中加入抗胸腺细胞球蛋白,霉酚酸酯和巴赛昔单抗。所有患者的抗感染管理,输血政策和支持治疗均相同。通过比较两个患者系列,晚期急性和广泛性慢性GVHD,TRM和复发的累积发生率未观察到统计学显着差异。中位随访时间为3.5年,HLA Id-sib和单倍接受者的5年DFS分别为37±6%和36±6%。从HLA同胞和单身捐献者那里移植的结果是可比的。无论HLA是否匹配,其他已知会影响移植结果的因素(例如供体-受者的年龄,性别和CMV状态组合)都可能促使寻找最佳的供体。
更新日期:2020-02-14
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