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Abstract
Background:
Many AML patients have received hematopoietic stem cell transplantation (HSCT) from HLA-matched unrelated donors. According to many of the previous reports, those patients could achieve long-term, disease-free survival after HSCT from multinational unrelated donors with tolerable transplant-related complications, even when there are HLA-mismatches.
Methods:
We present the results of 35 unrelated hematopoietic stem cell transplantations from multiple international donor banks including the Korean (n=24), and Japan Marrow Donor Program (n=3), the Taiwan Tzu Chi Marrow Donation Registry (n=6), as well as using Caucasian donors from the National Marrow Donor Program (n=2), for the treatment of AML patients.
Results:
The median age of patients was 36 (range: 16∼53) and the median follow-up duration was 21 months (range: 5∼60). Also, the median age of the donors was 28 (range: 20∼53). The majority of the patients had intermediate or unfavorable cytogenetic features. The main conditioning regimen we used consisted of cyclophosphamide plus TBI (n=31) with our standard GvHD prophylaxis that contained tacrolimus plus a short course of methotrexate. Some patients (n=10) received an additional two-day course of ATG (thymoglobulin, Sangstat) in addition to the standard regimen. All the transplanted patients achieved engraftment. The incidence of acute GvHD was 42%, and that of chronic GvHD was 56%. Four (11%) patients have relapsed to date. The two-year non-relapse transplant-related mortality was 26%. The estimated probability of DFS and the event-free survival at five-years were 80% and 53%, respectively.
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Fig. 1
Disease-free survival rate (A) and event-free survival rate (B) of mismatched unrelated donor HSCT from multinational donor registries worldwide.
Fig. 2
Defined outcomes according to the different donor registries included. Disease-free survival rate (A) and event-free survival rate (B) of mismatched unrelated donor HSCT from multinational donor registries.
Table 1.
Characteristics of donors (D) and AML recipients (R) in this study
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