Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age, and use of unrelated donors
Over the past four decades, allogeneic hematopoietic cell transplantation (alloHCT) has evolved as a curative modality for patients with hematologic diseases. This study describes changes in use, technique, and survival in a population-based cohort. The study included 38,060 patients with hematologi...
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| Vydáno v: | Journal of clinical oncology Ročník 31; číslo 19; s. 2437 |
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| Hlavní autoři: | , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
01.07.2013
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| ISSN: | 1527-7755, 1527-7755 |
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| Abstract | Over the past four decades, allogeneic hematopoietic cell transplantation (alloHCT) has evolved as a curative modality for patients with hematologic diseases. This study describes changes in use, technique, and survival in a population-based cohort.
The study included 38,060 patients with hematologic malignancies or disorders who underwent first alloHCT in a US or Canadian center from 1994 to 2005 and were reported to the Center for International Blood and Marrow Transplant Research.
AlloHCT as treatment for acute lymphoblastic (ALL) and myeloid leukemias (AML), myelodysplastic syndrome (MDS), and Hodgkin and non-Hodgkin lymphomas increased by 45%, from 2,520 to 3,668 patients annually. From 1994 to 2005, use of both peripheral (7% to 63%) [corrected] and cord blood increased (2% to 10%), whereas use of marrow decreased (90% to 27%). Despite a median age increase from 33 to 40 years and 165% [corrected] increase in unrelated donors for alloHCT, overall survival (OS) at day 100 significantly improved for patients with AML in first complete remission after myeloablative sibling alloHCT (85% to 94%; P < .001) and unrelated alloHCT (63% to 86%; P < .001); 1-year OS improved among those undergoing unrelated alloHCT (48% to 63%; P = .003) but not among those undergoing sibling alloHCT. Similar results were seen for ALL and MDS. Day-100 OS after cord blood alloHCT improved significantly from 60% to 78% (P < .001) for AML, ALL, MDS, and chronic myeloid leukemia. Use of reduced-intensity regimens increased, yielding OS rates similar to those of myeloablative regimens.
Survival for those undergoing alloHCT has significantly improved over time. However, new approaches are needed to further improve 1-year OS. |
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| AbstractList | Over the past four decades, allogeneic hematopoietic cell transplantation (alloHCT) has evolved as a curative modality for patients with hematologic diseases. This study describes changes in use, technique, and survival in a population-based cohort.PURPOSEOver the past four decades, allogeneic hematopoietic cell transplantation (alloHCT) has evolved as a curative modality for patients with hematologic diseases. This study describes changes in use, technique, and survival in a population-based cohort.The study included 38,060 patients with hematologic malignancies or disorders who underwent first alloHCT in a US or Canadian center from 1994 to 2005 and were reported to the Center for International Blood and Marrow Transplant Research.PATIENTS AND METHODSThe study included 38,060 patients with hematologic malignancies or disorders who underwent first alloHCT in a US or Canadian center from 1994 to 2005 and were reported to the Center for International Blood and Marrow Transplant Research.AlloHCT as treatment for acute lymphoblastic (ALL) and myeloid leukemias (AML), myelodysplastic syndrome (MDS), and Hodgkin and non-Hodgkin lymphomas increased by 45%, from 2,520 to 3,668 patients annually. From 1994 to 2005, use of both peripheral (7% to 63%) [corrected] and cord blood increased (2% to 10%), whereas use of marrow decreased (90% to 27%). Despite a median age increase from 33 to 40 years and 165% [corrected] increase in unrelated donors for alloHCT, overall survival (OS) at day 100 significantly improved for patients with AML in first complete remission after myeloablative sibling alloHCT (85% to 94%; P < .001) and unrelated alloHCT (63% to 86%; P < .001); 1-year OS improved among those undergoing unrelated alloHCT (48% to 63%; P = .003) but not among those undergoing sibling alloHCT. Similar results were seen for ALL and MDS. Day-100 OS after cord blood alloHCT improved significantly from 60% to 78% (P < .001) for AML, ALL, MDS, and chronic myeloid leukemia. Use of reduced-intensity regimens increased, yielding OS rates similar to those of myeloablative regimens.RESULTSAlloHCT as treatment for acute lymphoblastic (ALL) and myeloid leukemias (AML), myelodysplastic syndrome (MDS), and Hodgkin and non-Hodgkin lymphomas increased by 45%, from 2,520 to 3,668 patients annually. From 1994 to 2005, use of both peripheral (7% to 63%) [corrected] and cord blood increased (2% to 10%), whereas use of marrow decreased (90% to 27%). Despite a median age increase from 33 to 40 years and 165% [corrected] increase in unrelated donors for alloHCT, overall survival (OS) at day 100 significantly improved for patients with AML in first complete remission after myeloablative sibling alloHCT (85% to 94%; P < .001) and unrelated alloHCT (63% to 86%; P < .001); 1-year OS improved among those undergoing unrelated alloHCT (48% to 63%; P = .003) but not among those undergoing sibling alloHCT. Similar results were seen for ALL and MDS. Day-100 OS after cord blood alloHCT improved significantly from 60% to 78% (P < .001) for AML, ALL, MDS, and chronic myeloid leukemia. Use of reduced-intensity regimens increased, yielding OS rates similar to those of myeloablative regimens.Survival for those undergoing alloHCT has significantly improved over time. However, new approaches are needed to further improve 1-year OS.CONCLUSIONSurvival for those undergoing alloHCT has significantly improved over time. However, new approaches are needed to further improve 1-year OS. Over the past four decades, allogeneic hematopoietic cell transplantation (alloHCT) has evolved as a curative modality for patients with hematologic diseases. This study describes changes in use, technique, and survival in a population-based cohort. The study included 38,060 patients with hematologic malignancies or disorders who underwent first alloHCT in a US or Canadian center from 1994 to 2005 and were reported to the Center for International Blood and Marrow Transplant Research. AlloHCT as treatment for acute lymphoblastic (ALL) and myeloid leukemias (AML), myelodysplastic syndrome (MDS), and Hodgkin and non-Hodgkin lymphomas increased by 45%, from 2,520 to 3,668 patients annually. From 1994 to 2005, use of both peripheral (7% to 63%) [corrected] and cord blood increased (2% to 10%), whereas use of marrow decreased (90% to 27%). Despite a median age increase from 33 to 40 years and 165% [corrected] increase in unrelated donors for alloHCT, overall survival (OS) at day 100 significantly improved for patients with AML in first complete remission after myeloablative sibling alloHCT (85% to 94%; P < .001) and unrelated alloHCT (63% to 86%; P < .001); 1-year OS improved among those undergoing unrelated alloHCT (48% to 63%; P = .003) but not among those undergoing sibling alloHCT. Similar results were seen for ALL and MDS. Day-100 OS after cord blood alloHCT improved significantly from 60% to 78% (P < .001) for AML, ALL, MDS, and chronic myeloid leukemia. Use of reduced-intensity regimens increased, yielding OS rates similar to those of myeloablative regimens. Survival for those undergoing alloHCT has significantly improved over time. However, new approaches are needed to further improve 1-year OS. |
| Author | McCarthy, Jr, Philip L Hale, Gregory A Lazarus, Hillard M Rizzo, J Douglas Parsons, Susan Isola, Luis M Maziarz, Richard T Majhail, Navneet S Hahn, Theresa Loberiza, Fausto Joffe, Steven Bredeson, Christopher Lee, Stephanie J Hassebroek, Anna Gajewski, James L Lemaistre, Charles F |
| Author_xml | – sequence: 1 givenname: Theresa surname: Hahn fullname: Hahn, Theresa organization: National Marrow Donor Program, Minneapolis, MN 55413, USA – sequence: 2 givenname: Philip L surname: McCarthy, Jr fullname: McCarthy, Jr, Philip L – sequence: 3 givenname: Anna surname: Hassebroek fullname: Hassebroek, Anna – sequence: 4 givenname: Christopher surname: Bredeson fullname: Bredeson, Christopher – sequence: 5 givenname: James L surname: Gajewski fullname: Gajewski, James L – sequence: 6 givenname: Gregory A surname: Hale fullname: Hale, Gregory A – sequence: 7 givenname: Luis M surname: Isola fullname: Isola, Luis M – sequence: 8 givenname: Hillard M surname: Lazarus fullname: Lazarus, Hillard M – sequence: 9 givenname: Stephanie J surname: Lee fullname: Lee, Stephanie J – sequence: 10 givenname: Charles F surname: Lemaistre fullname: Lemaistre, Charles F – sequence: 11 givenname: Fausto surname: Loberiza fullname: Loberiza, Fausto – sequence: 12 givenname: Richard T surname: Maziarz fullname: Maziarz, Richard T – sequence: 13 givenname: J Douglas surname: Rizzo fullname: Rizzo, J Douglas – sequence: 14 givenname: Steven surname: Joffe fullname: Joffe, Steven – sequence: 15 givenname: Susan surname: Parsons fullname: Parsons, Susan – sequence: 16 givenname: Navneet S surname: Majhail fullname: Majhail, Navneet S |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23715573$$D View this record in MEDLINE/PubMed |
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| SubjectTerms | Adolescent Adult Age Factors Aged Canada - epidemiology Child Child, Preschool Cohort Studies Female Hematologic Neoplasms - mortality Hematologic Neoplasms - surgery Hematopoietic Stem Cell Transplantation - utilization Hodgkin Disease - mortality Hodgkin Disease - surgery Humans Infant Leukemia, Myeloid, Acute - mortality Leukemia, Myeloid, Acute - surgery Lymphoma, Non-Hodgkin - mortality Lymphoma, Non-Hodgkin - surgery Male Middle Aged Myelodysplastic Syndromes - mortality Myelodysplastic Syndromes - surgery Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality Precursor Cell Lymphoblastic Leukemia-Lymphoma - surgery Retrospective Studies SEER Program Survival Analysis Survival Rate Transplantation, Homologous United States - epidemiology Unrelated Donors |
| Title | Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age, and use of unrelated donors |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/23715573 https://www.proquest.com/docview/1373439701 |
| Volume | 31 |
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