Outcomes of pediatric bone marrow transplantation for leukemia and myelodysplasia using matched sibling, mismatched related, or matched unrelated donors

Peter J. Shaw, Fangyu Kan, Kwang Woo Ahn, Stephen R. Spellman, Mahmoud Aljurf, Mouhab Ayas, Michael Burke, Mitchell S. Cairo, Allen R. Chen, Stella M. Davies, Haydar Frangoul, James Gajewski, Robert Peter Gale, Kamar Godder, Gregory A. Hale, Martin B.A. Heemskerk, John Horan, Naynesh Kamani, Kimberly A. Kasow, Ka Wah ChanStephanie J. Lee, Wing H. Leung, Victor A. Lewis, David Miklos, Machteld Oudshoorn, Effie W. Petersdorf, Olle Ringdén, Jean Sanders, Kirk R. Schultz, Adriana Seber, Michelle Setterholm, Donna A. Wall, Lolie Yu, Michael A. Pulsipher

Research output: Contribution to journalArticle

Abstract

Although some trials have allowed matched or single human leukocyte antigen (HLA)-mismatched related donors (mmRDs) along with HLA-matched sibling donors (MSDs) for pediatric bone marrow transplantation in early-stage hematologic malignancies, whether mmRD grafts lead to similar outcomes is not known.We compared patients < 18 years old reported to the Center for International Blood and Marrow Transplant Research with acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, and myelodysplastic syndrome undergoing allogeneic T-replete, myeloablative bone marrow transplantation between 1993 and 2006. In total, patients receiving bone marrow from 1208 MSDs, 266 8/8 allelic-matched unrelated donors (URDs), and 151 0-1 HLA-antigen mmRDs were studied. Multivariate analysis showed that recipients of MSD transplants had less transplantation-related mortality, acute graft-versus-host disease (GVHD), and chronic GVHD, along with better disease-free and overall survival than the URD and mmRD groups. No differences were observed in transplant-related mortality, acute and chronic GVHD, relapse, disease-free survival, or overall survival between the mmRD and URD groups. These data show that mmRD and 8/8 URD outcomes are similar, whereas MSD outcomes are superior to the other 2 sources. Whether allele level typing could identify mmRD recipients with better outcomes will not be known unless centers alter practice and type mmRD at the allele level.

Original languageEnglish (US)
Pages (from-to)4007-4015
Number of pages9
JournalBlood
Volume116
Issue number19
DOIs
StatePublished - Nov 11 2010

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Shaw, P. J., Kan, F., Ahn, K. W., Spellman, S. R., Aljurf, M., Ayas, M., Burke, M., Cairo, M. S., Chen, A. R., Davies, S. M., Frangoul, H., Gajewski, J., Gale, R. P., Godder, K., Hale, G. A., Heemskerk, M. B. A., Horan, J., Kamani, N., Kasow, K. A., ... Pulsipher, M. A. (2010). Outcomes of pediatric bone marrow transplantation for leukemia and myelodysplasia using matched sibling, mismatched related, or matched unrelated donors. Blood, 116(19), 4007-4015. https://doi.org/10.1182/blood-2010-01-261958