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Article: Unmanipulated bone marrow transplantation from one-HLA locus mismatched siblings carries high transplant-related mortality in Chinese patients

TitleUnmanipulated bone marrow transplantation from one-HLA locus mismatched siblings carries high transplant-related mortality in Chinese patients
Authors
Issue Date2001
Citation
Haematologica, 2001, v. 86 n. 5, p. 518-522 How to Cite?
AbstractBackground and Objectives. We compared the outcome of bone marrow transplantation (BMT) from HLA-identical siblings (MSD) and one HLA-locus mismatched siblings (PMSD) in Chinese patients with hematologic malignancies in terms of transplant-related mortality (TRM) and disease relapse to see whether PMSD can feasibly increase the availability of donors in our population. Design and Methods. Medical records of patients who had received a BMT from sibling donors in the Queen Mary Hospital, Hong Kong, from March 1990 to February 2000 were reviewed (MSD 326, PMSD 20). Patients and their donors were matched for HLA-A, -B and DRB1 loci using standard serologic methods as well as polymerase chain reactionsequence specific primers. All patients received standard anti-microbials and graft-versus-host disease (GVHD) prophylaxis including cyclosporin A and a short course of methotrexate. Results. A total of 346 BMT patients were analyzed of whom 326 and 20 patients had received transplants from matched and one locus mismatched siblings, respectively. Patients receiving BMT from PMSD had a significantly higher TRM than those receiving their BMT from MSD (p=0.0016). Six patients received BMT from HLA-DR PMSD: one died 2 months post-BMT as a result of post-transplantation-related lymphoproliferative disease. Fourteen patients received BMT from HLA-A or -B PMSD: 11 of these patients died after a median of 5.6 months (range 0.6-13.7 months) due to severe GVHD (n=5), graft failure (n=2), bleeding (n=1), leukemic relapse (n=2) and thrombotic thrombocytopenic purpura (n=1). Two out of the three survivors had primary graft failure: one of these two required infusion of back-up marrow and the other had autologous regeneration. Patients in the PMSD group were at greater risk of developing severe GVHD than their MSD-recipient counterparts (p<0.001). There was no significant difference in the probability of disease relapse between patients who received BMT from MSD or PMSD. Interpretation and Conclusions. BMT from PMSD (especially those with mismatches at HLA class I loci) carried a higher risk of TRM and morbidity than BMTfrom MSD in our population. ©2001, Ferrata Storti Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/162526
ISSN
2015 Impact Factor: 6.671
2015 SCImago Journal Rankings: 3.010
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLeung, AYHen_US
dc.contributor.authorLie, AKWen_US
dc.contributor.authorAu, WYen_US
dc.contributor.authorHawkins, BRen_US
dc.contributor.authorKwong, YLen_US
dc.contributor.authorLiang, Ren_US
dc.date.accessioned2012-09-05T05:20:47Z-
dc.date.available2012-09-05T05:20:47Z-
dc.date.issued2001en_US
dc.identifier.citationHaematologica, 2001, v. 86 n. 5, p. 518-522en_US
dc.identifier.issn0390-6078en_US
dc.identifier.urihttp://hdl.handle.net/10722/162526-
dc.description.abstractBackground and Objectives. We compared the outcome of bone marrow transplantation (BMT) from HLA-identical siblings (MSD) and one HLA-locus mismatched siblings (PMSD) in Chinese patients with hematologic malignancies in terms of transplant-related mortality (TRM) and disease relapse to see whether PMSD can feasibly increase the availability of donors in our population. Design and Methods. Medical records of patients who had received a BMT from sibling donors in the Queen Mary Hospital, Hong Kong, from March 1990 to February 2000 were reviewed (MSD 326, PMSD 20). Patients and their donors were matched for HLA-A, -B and DRB1 loci using standard serologic methods as well as polymerase chain reactionsequence specific primers. All patients received standard anti-microbials and graft-versus-host disease (GVHD) prophylaxis including cyclosporin A and a short course of methotrexate. Results. A total of 346 BMT patients were analyzed of whom 326 and 20 patients had received transplants from matched and one locus mismatched siblings, respectively. Patients receiving BMT from PMSD had a significantly higher TRM than those receiving their BMT from MSD (p=0.0016). Six patients received BMT from HLA-DR PMSD: one died 2 months post-BMT as a result of post-transplantation-related lymphoproliferative disease. Fourteen patients received BMT from HLA-A or -B PMSD: 11 of these patients died after a median of 5.6 months (range 0.6-13.7 months) due to severe GVHD (n=5), graft failure (n=2), bleeding (n=1), leukemic relapse (n=2) and thrombotic thrombocytopenic purpura (n=1). Two out of the three survivors had primary graft failure: one of these two required infusion of back-up marrow and the other had autologous regeneration. Patients in the PMSD group were at greater risk of developing severe GVHD than their MSD-recipient counterparts (p<0.001). There was no significant difference in the probability of disease relapse between patients who received BMT from MSD or PMSD. Interpretation and Conclusions. BMT from PMSD (especially those with mismatches at HLA class I loci) carried a higher risk of TRM and morbidity than BMTfrom MSD in our population. ©2001, Ferrata Storti Foundation.en_US
dc.languageengen_US
dc.relation.ispartofHaematologicaen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshBone Marrow Transplantation - Immunology - Methods - Mortalityen_US
dc.subject.meshChinaen_US
dc.subject.meshFemaleen_US
dc.subject.meshHematologic Neoplasms - Mortality - Therapyen_US
dc.subject.meshHistocompatibility - Immunologyen_US
dc.subject.meshHistocompatibility Testingen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNuclear Familyen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshTissue Donorsen_US
dc.titleUnmanipulated bone marrow transplantation from one-HLA locus mismatched siblings carries high transplant-related mortality in Chinese patientsen_US
dc.typeArticleen_US
dc.identifier.emailLeung, AYH:ayhleung@hku.hken_US
dc.identifier.emailKwong, YL:ylkwong@hku.hken_US
dc.identifier.emailLiang, R:rliang@hku.hken_US
dc.identifier.authorityLeung, AYH=rp00265en_US
dc.identifier.authorityKwong, YL=rp00358en_US
dc.identifier.authorityLiang, R=rp00345en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid11410416-
dc.identifier.scopuseid_2-s2.0-0035349003en_US
dc.identifier.hkuros60082-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035349003&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume86en_US
dc.identifier.issue5en_US
dc.identifier.spage518en_US
dc.identifier.epage522en_US
dc.identifier.isiWOS:000168808000013-
dc.publisher.placeItalyen_US
dc.identifier.scopusauthoridLeung, AYH=7403012668en_US
dc.identifier.scopusauthoridLie, AKW=24284842400en_US
dc.identifier.scopusauthoridAu, WY=7202383089en_US
dc.identifier.scopusauthoridHawkins, BR=35944486200en_US
dc.identifier.scopusauthoridKwong, YL=7102818954en_US
dc.identifier.scopusauthoridLiang, R=26643224900en_US

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