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Blood, 26 March 2009, Vol. 113, No. 13, pp. 3110-3118. Prepublished online as a Blood First Edition Paper on December 4, 2008; DOI 10.1182/blood-2008-07-163212. This Article Full Text Full Text (PDF) Supplemental Table All Versions of this Article: blood-2008-07-163212v1 113/13/3110    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Ringdén, O. Articles by Arora, M. Search for Related Content PubMed PubMed Citation Articles by Ringdén, O. Articles by Arora, M. Related Collections Transplantation Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION The graft-versus-leukemia effect using matched unrelated donors is not superior to HLA-identical siblings for hematopoietic stem cell transplantation Olle Ringdén1, Steven Z. Pavletic2, Claudio Anasetti3, A. John Barrett2, Tao Wang4, Dan Wang4, Joseph H. Antin5, Paolo Di Bartolomeo6, Brian J. Bolwell7, Christopher Bredeson4, Mitchell S. Cairo8, Robert P. Gale9, Vikas Gupta10, Theresa Hahn11, Gregory A. Hale12, Jorg Halter13, Madan Jagasia14, Mark R. Litzow15, Franco Locatelli16, David I. Marks17, Philip L. McCarthy11, Morton J. Cowan18, Effie W. Petersdorf19, James A. Russell20, Gary J. Schiller21, Harry Schouten22, Stephen Spellman4, Leo F. Verdonck23, John R. Wingard24, Mary M. Horowitz4, and Mukta Arora25 1 Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden; 2 Experimental Transplantation and Immunology Branch, National Institutes of Health, Bethesda, MD; 3 BMT Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; 4 Center for International Blood and Marrow Transplant Research (CIBMTR), Medical College of Wisconsin, Milwaukee; 5 Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA; 6 Department of Haematology, Ospedale Civile, Pescara, Italy; 7 Cleveland Clinic Foundation, OH; 8 Pediatrics, Columbia University Medical Center, New York, NY; 9 Center for Advanced Studies in Leukemia, Los Angeles, CA; 10 BMT Program, Princess Margaret Hospital, Toronto, ON; 11 Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY; 12 St Jude Children's Research Hospital, Memphis, TN; 13 University Hospital Basel, Basel, Switzerland; 14 Hematology/Stem Cell Transplantation, Vanderbilt University Medical Center, Nashville, TN; 15 Mayo Clinic, Rochester, MN; 16 Pediatric Hematology-Oncology, IRCCS Policlinico San Matteo, Pavia, Italy; 17 Adult BMT Unit, United Bristol Healthcare Trust, Bristol, United Kingdom; 18 BMT Division, University of California, San Francisco (UCSF) Children's Hospital; 19 Fred Hutchinson Cancer Research Center, Seattle, WA; 20 Department of Medicine, Tom Baker Cancer Center, Calgary, AB; 21 University of California at Los Angeles (UCLA) School of Medicine; 22 University Hospital Maastricht, Maastricht, The Netherlands; 23 University Hospital Utrecht, Utrecht, The Netherlands; 24 University of Florida, Health Science Center (HSC) College of Medicine, Gainesville; and 25 University of Minnesota, Minneapolis Do some patients benefit from an unrelated donor (URD) transplant because of a stronger graft-versus-leukemia (GVL) effect? We analyzed 4099 patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic myeloid leukemia (CML) undergoing a myeloablative allogeneic hematopoietic cell transplantation (HCT) from an URD (8/8 human leukocyte antigen [HLA]–matched, n = 941) or HLA-identical sibling donor (n = 3158) between 1995 and 2004 reported to the CIBMTR. In the Cox regression model, acute and chronic GVHD were added as time-dependent variables. In multivariate analysis, URD transplant recipients had a higher risk for transplantation-related mortality (TRM; relative risk [RR], 2.76; P < .001) and relapse (RR, 1.50; P < .002) in patients with AML, but not ALL or CML. Chronic GVHD was associated with a lower relapse risk in all diagnoses. Leukemia-free survival (LFS) was decreased in patients with AML without acute GVHD receiving a URD transplant (RR, 2.02; P < .001) but was comparable to those receiving HLA-identical sibling transplants in patients with ALL and CML. In patients without GVHD, multivariate analysis showed similar risk of relapse but decreased LFS for URD transplants for all 3 diagnoses. In conclusion, risk of relapse was the same (ALL, CML) or worse (AML) in URD transplant recipients compared with HLA-identical sibling transplant recipients, suggesting a similar GVL effect. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: O. Ringden, M. Labopin, G. Ehninger, D. Niederwieser, R. Olsson, N. Basara, J. Finke, R. Schwerdtfeger, M. Eder, D. Bunjes, et al. Reduced Intensity Conditioning Compared With Myeloablative Conditioning Using Unrelated Donor Transplants in Patients With Acute Myeloid Leukemia J. Clin. Oncol., September 20, 2009; 27(27): 4570 - 4577. [Abstract] [Full Text] [PDF]

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