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
Authors: de Witte, Theo ×
Brand, Ronald
van Biezen, Anja
Mufti, Ghulam
Ruutu, Tapani
Finke, Jürgen
von dem Borne, Peter
Vitek, Antonin
Delforge, Michel
Alessandrino, Paolo
Harlahakis, Nicolas
Russell, Nigel
Martino, Roberto
Verdonck, Leo
Kröger, Nicholas
Niederwieser, Dietger #
Issue Date: Sep-2009
Publisher: Blackwell Scientific Publications
Series Title: British Journal of Haematology vol:146 issue:6 pages:627-636
Abstract: 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 = 0.05) and a lower NRM (P = 0.02) 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 = 0.02). 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.
ISSN: 0007-1048
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hematology Section (-)
× corresponding author
# (joint) last author

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