Stem cell transplantation from identical twins in patients with myelodysplastic syndromes

N. Kröger; R. Brand; A. van Biezen; D. Bron; D. Blaise; E. Hellström-Lindberg; G. Gahrton; R. Powles; T. Littlewood; B. Chapuis; A. Zander; V. Koza; D. Niederwieser; T. de Witte; A. Gratwohl; R. Barge; D. Bunjes; A. Devergie; J. L. Harousseau; B. Simonsson; J. Reiffers; E. P. Alessandrino; B. Hertenstein; H. J. Kolb; M. Attal; A. Vitek; M. A. Sanz; J. Holowiecki; J. M. Moraleda; A. C. Newland; J. Finke

doi:10.1038/sj.bmt.1704701

Stem cell transplantation from identical twins in patients with myelodysplastic syndromes

N. Kröger, R. Brand, A. van Biezen, D. Bron, D. Blaise, E. Hellström-Lindberg, G. Gahrton, R. Powles, T. Littlewood, B. Chapuis, A. Zander, V. Koza, D. Niederwieser, T. de Witte, A. Gratwohl, R. Barge, D. Bunjes, A. Devergie, J. L. Harousseau, B. SimonssonJ. Reiffers, E. P. Alessandrino, B. Hertenstein, H. J. Kolb, M. Attal, A. Vitek, M. A. Sanz, J. Holowiecki, J. M. Moraleda, A. C. Newland, J. Finke

IRCCS Fondazione Policlinico San Matteo

Research output: Contribution to journal › Article › peer-review

Abstract

In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-dentical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P = 0.02) and 16 vs 26 days (P = 0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27%; P = 0.05). The 5 year cumulative incidence of relapse was 32% (95% CI: 29-35%) for the siblings and 39% (95% CI: 26-60%; P = 0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34% (95% CI: 14-54%) Ps 28% (95% CI: 25-31 %; P = 0.2) and 36% (95% CI: 15-57%) vs 32% (95% CI: 29-35%; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95% CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95% CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95% CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.

Original language	English
Pages (from-to)	37-43
Number of pages	7
Journal	Bone Marrow Transplantation
Volume	35
Issue number	1
DOIs	https://doi.org/10.1038/sj.bmt.1704701
Publication status	Published - Jan 2005

Keywords

Allogeneic stem cell transplantation
Myelodysplastic syndrome
Syngeneic stem cell transplantation

ASJC Scopus subject areas

Hematology
Transplantation

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10.1038/sj.bmt.1704701

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Kröger, N., Brand, R., van Biezen, A., Bron, D., Blaise, D., Hellström-Lindberg, E., Gahrton, G., Powles, R., Littlewood, T., Chapuis, B., Zander, A., Koza, V., Niederwieser, D., de Witte, T., Gratwohl, A., Barge, R., Bunjes, D., Devergie, A., Harousseau, J. L., ... Finke, J. (2005). Stem cell transplantation from identical twins in patients with myelodysplastic syndromes. Bone Marrow Transplantation, 35(1), 37-43. https://doi.org/10.1038/sj.bmt.1704701

Kröger, N, Brand, R, van Biezen, A, Bron, D, Blaise, D, Hellström-Lindberg, E, Gahrton, G, Powles, R, Littlewood, T, Chapuis, B, Zander, A, Koza, V, Niederwieser, D, de Witte, T, Gratwohl, A, Barge, R, Bunjes, D, Devergie, A, Harousseau, JL, Simonsson, B, Reiffers, J, Alessandrino, EP, Hertenstein, B, Kolb, HJ, Attal, M, Vitek, A, Sanz, MA, Holowiecki, J, Moraleda, JM, Newland, AC & Finke, J 2005, 'Stem cell transplantation from identical twins in patients with myelodysplastic syndromes', Bone Marrow Transplantation, vol. 35, no. 1, pp. 37-43. https://doi.org/10.1038/sj.bmt.1704701

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title = "Stem cell transplantation from identical twins in patients with myelodysplastic syndromes",

abstract = "In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-dentical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P = 0.02) and 16 vs 26 days (P = 0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27%; P = 0.05). The 5 year cumulative incidence of relapse was 32% (95% CI: 29-35%) for the siblings and 39% (95% CI: 26-60%; P = 0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34% (95% CI: 14-54%) Ps 28% (95% CI: 25-31 %; P = 0.2) and 36% (95% CI: 15-57%) vs 32% (95% CI: 29-35%; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95% CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95% CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95% CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.",

keywords = "Allogeneic stem cell transplantation, Myelodysplastic syndrome, Syngeneic stem cell transplantation",

author = "N. Kr{\"o}ger and R. Brand and {van Biezen}, A. and D. Bron and D. Blaise and E. Hellstr{\"o}m-Lindberg and G. Gahrton and R. Powles and T. Littlewood and B. Chapuis and A. Zander and V. Koza and D. Niederwieser and {de Witte}, T. and A. Gratwohl and R. Barge and D. Bunjes and A. Devergie and Harousseau, {J. L.} and B. Simonsson and J. Reiffers and Alessandrino, {E. P.} and B. Hertenstein and Kolb, {H. J.} and M. Attal and A. Vitek and Sanz, {M. A.} and J. Holowiecki and Moraleda, {J. M.} and Newland, {A. C.} and J. Finke",

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doi = "10.1038/sj.bmt.1704701",

language = "English",

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T1 - Stem cell transplantation from identical twins in patients with myelodysplastic syndromes

AU - Kröger, N.

AU - Brand, R.

AU - van Biezen, A.

AU - Bron, D.

AU - Blaise, D.

AU - Hellström-Lindberg, E.

AU - Gahrton, G.

AU - Powles, R.

AU - Littlewood, T.

AU - Chapuis, B.

AU - Zander, A.

AU - Koza, V.

AU - Niederwieser, D.

AU - de Witte, T.

AU - Gratwohl, A.

AU - Barge, R.

AU - Bunjes, D.

AU - Devergie, A.

AU - Harousseau, J. L.

AU - Simonsson, B.

AU - Reiffers, J.

AU - Alessandrino, E. P.

AU - Hertenstein, B.

AU - Kolb, H. J.

AU - Attal, M.

AU - Vitek, A.

AU - Sanz, M. A.

AU - Holowiecki, J.

AU - Moraleda, J. M.

AU - Newland, A. C.

AU - Finke, J.

PY - 2005/1

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N2 - In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-dentical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P = 0.02) and 16 vs 26 days (P = 0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27%; P = 0.05). The 5 year cumulative incidence of relapse was 32% (95% CI: 29-35%) for the siblings and 39% (95% CI: 26-60%; P = 0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34% (95% CI: 14-54%) Ps 28% (95% CI: 25-31 %; P = 0.2) and 36% (95% CI: 15-57%) vs 32% (95% CI: 29-35%; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95% CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95% CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95% CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.

AB - In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-dentical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P = 0.02) and 16 vs 26 days (P = 0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27%; P = 0.05). The 5 year cumulative incidence of relapse was 32% (95% CI: 29-35%) for the siblings and 39% (95% CI: 26-60%; P = 0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34% (95% CI: 14-54%) Ps 28% (95% CI: 25-31 %; P = 0.2) and 36% (95% CI: 15-57%) vs 32% (95% CI: 29-35%; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95% CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95% CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95% CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.

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KW - Myelodysplastic syndrome

KW - Syngeneic stem cell transplantation

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Stem cell transplantation from identical twins in patients with myelodysplastic syndromes

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Keywords

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