Originally published as JCO Early Release 10.1200/JCO.2006.08.0952 on November 20 2006

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Allogeneic Marrow Stem-Cell Transplantation From Human Leukocyte Antigen–Identical Siblings Versus Human Leukocyte Antigen–Allelic–Matched Unrelated Donors (10/10) in Patients With Standard-Risk Hematologic Malignancy: A Prospective Study From the French Society of Bone Marrow Transplantation and Cell Therapy

Ibrahim Yakoub-Agha, Florence Mesnil, Mathieu Kuentz, Jean Michel Boiron, Norbert Ifrah, Noel Milpied, Sami Chehata, Helene Esperou, Jean-Paul Vernant, Mauricette Michallet, Agnes Buzyn, Nicole Gratecos, Jean Yves Cahn, Jean Henri Bourhis, Zina Chir, Colette Raffoux, Gerard Socié, Jean Louis Golmard, Jean-Pierre Jouet

From Lille; Agence de la biomédecine, St Denis; Créteil; Bordeaux; Angers; Nantes; Institute Gustave Roussy, Villejuif; Hospital St Louis, Paris; Hôpital Pitié-Salpetrieère, Paris; Hôpital Edouard Herriot, Lyon; Hôpital Necker, Paris; Nice; Besançon; Société Française de Greffe De Moelle et Thérapie Cellulaire, St Denis; register France Greffe de Moelle, St Denis; Unite de biostatistique, Université de Jussieu, Paris, France

Address reprint requests to Jean-Pierre Jouet, MD, UAM allogreffes de CSH, Maladies du Sang, CHRU de Lille, F-59037, France; e-mail: jpjouet{at}chru-lille.fr

PURPOSE: To investigate the influence of donor type (human leukocyte antigen [HLA] -identical sibling donor versus HLA-A–, HLA-B–, HLA-Cw–, HLA-DRB1–, and HLA-DQB1–identical unrelated donors, or so-called 10/10) on the outcome of patients who underwent allogeneic stem-cell transplantation (alloSCT), adjusting for other prognostic factors, in patients with standard-risk hematologic malignancy.

PATIENTS AND METHODS: Between March 2000 and January 2003, we prospectively investigated the outcome of 236 consecutive patients with standard-risk malignancy from 12 French centers. Fifty-five patients underwent alloSCT from an unrelated HLA-identical donor at the allelic level, whereas 181 patients received an alloSCT from an HLA-identical sibling. Diagnoses included acute leukemia (n = 175), chronic myeloid leukemia (n = 43), and myelodysplastic syndrome (MDS; n = 18). All patients received unmodified marrow graft following myeloablative conditioning with cyclophosphamide and total-body irradiation. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and short-course methotrexate in all patients.

RESULTS: In multivariable analysis, overall survival and transplantation-related mortality were adversely influenced by recipient cytomegalovirus (CMV) -positive serology, age of donor older than 37 years, and the occurrence of acute grade II GVHD. Event-free survival rates were lower for patients with recipient CMV-positive serology. Acute grades II to IV GVHD rates were higher for patients with chronic myeloid leukemia (CML). No factor was found to influence either relapse or acute grades III to IV GVHD. The effect of donor type was nonsignificant for all criteria.

CONCLUSION: In patients with standard-risk malignancy, transplantation from unrelated HLA-allellically matched donors led to outcomes similar to those from HLA-identical sibling donors.

published online ahead of print at www.jco.org on November 20, 2006.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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