scholarly journals Effect of Cytomegalovirus Infection on 1‐Year Mortality Rates Among Recipients of Allogeneic Bone Marrow Transplants

1998 ◽  
Vol 26 (3) ◽  
pp. 606-610 ◽  
Author(s):  
Atul Humar ◽  
Serena Wood ◽  
Jeff Lipton ◽  
Hans Messner ◽  
Jacinta Meharchand ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cytomegalovirus Infection ◽  
Mortality Rates ◽  
Allogeneic Bone Marrow ◽  
Allogeneic Bone ◽  
Bone Marrow Transplants

Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings.

1997 ◽  
Vol 15 (5) ◽  
pp. 1767-1777 ◽  
Author(s):  
R Szydlo ◽  
J M Goldman ◽  
J P Klein ◽  
R P Gale ◽  
R C Ash ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Treatment Failure ◽  
Allogeneic Bone Marrow ◽  
Myelogenous Leukemia ◽  
Allogeneic Bone ◽  
Bone Marrow Transplants ◽  
Hla Antigen ◽  
Unrelated Donors ◽  
Alternative Donor ◽  
Related Mortality

PURPOSE To compare outcomes of bone marrow transplants for leukemia from HLA-identical siblings, haploidentical HLA-mismatched relatives, and HLA-matched and mismatched unrelated donors. PATIENTS A total of 2,055 recipients of allogeneic bone marrow transplants for chronic myelogenous leukemia (CML), acute myelogenous leukemia (AML), and acute lymphoblastic leukemia (ALL) were entered onto the study. Transplants were performed between 1985 and 1991 and reported to the International Bone Marrow Transplant Registry (IBMTR). Donors were HLA-identical siblings (n = 1,224); haploidentical relatives mismatched for one (n = 238) or two (n = 102) HLA-A, -B, or -DR antigens; or unrelated persons who were HLA-matched (n = 383) or mismatched for one HLA-A, -B, or -DR antigen (n = 108). HLA typing was performed using serologic techniques. RESULTS Transplant-related mortality was significantly higher after alternative donor transplants than after HLA-identical sibling transplants. Among patients with early leukemia (CML in chronic phase or acute leukemia in first remission), 3-year transplant-related mortality (+/-SE) was 21% +/- 2% after HLA-identical sibling transplants and greater than 50% after all types of alternative donor transplants studied. Among patients with early leukemia, relative risks of treatment failure (inverse of leukemia-free survival), using HLA-identical sibling transplants as the reference group, were 2.43 (P < .0001) with 1-HLA-antigen-mismatched related donors, 3.79 (P < .0001) with 2-HLA-antigen-mismatched related donors, 2.11 (P < .0001) with HLA-matched unrelated donors, and 3.33 (P < .0001) with 1-HLA-antigen-mismatched unrelated donors. For patients with more advanced leukemia, differences in treatment failure were less striking: 1-HLA-antigen-mismatched relatives, 1.22 (P = not significant [NS]); 2-HLA-antigen-mismatched relatives, 1.81 (P < .0001); HLA-matched unrelated donors, 1.39 (P = .002); and 1-HLA-antigen-mismatched unrelated donors, 1.63 (P = .002). CONCLUSION Although transplants from alternative donors are effective in some patients with leukemia, treatment failure is higher than after HLA-identical sibling transplants. Outcome depends on leukemia state, donor-recipient relationship, and degree of HLA matching. In early leukemia, alternative donor transplants have a more than twofold increased risk of treatment failure compared with HLA-identical sibling transplants. This difference is less in advanced leukemia.

Small-Airways Disease in Recipients of Allogeneic Bone Marrow Transplants

Medicine ◽  
1987 ◽  
Vol 66 (5) ◽  
pp. 327-340 ◽  
Author(s):  
CHARLES K. CHAN ◽  
ROBERT H. HYLAND ◽  
MICHAEL A. HUTCHEON ◽  
MARK D. MINDEN ◽  
MICHAEL A. ALEXANDER ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Allogeneic Bone Marrow ◽  
Small Airways ◽  
Allogeneic Bone ◽  
Bone Marrow Transplants
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