Both optimal matching and procedure duration influence survival of patients after unrelated donor hematopoietic stem cell transplantation.

Bone Marrow Research Pub Date : 2012-01-01 Epub Date: 2012-10-22 DOI:10.1155/2012/873695
Sylwia Mizia, Dorota Dera-Joachimiak, Malgorzata Polak, Katarzyna Koscinska, Mariola Sedzimirska, Andrzej Lange
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Abstract

Eighty-six patients suffering from hematological malignancies, immunodeficiencies, and aplastic anemias received alloHSCT from unrelated donors. Donors were selected from the BMDW files and further matching was performed according to the confirmatory typing procedure with the use of PCR SSP and that based on sequencing. The time from the clinical request of the donor search to the final decision of clinicians accepting the donor was from 0.3 to 17.8 months (median 1.6). Matching was analyzed at the allele level, and 50, 27, and 9 donor-recipient pairs were 10/10 matched, mismatched in one or more alleles, respectively. In an univariate analysis we found better survival if patients were transplanted: (i) from donors matched 10/10 (P = 0.025), (ii) not from female donor to male recipient (P = 0.037), (iii) in female donation from those with ≤1 pregnancy than multiparous (P = 0.075). Notably, it became apparent that duration of the confirmatory typing process affected the survival (HR = 1.138, P = 0.013). In multivariate analysis only the level of matching and the duration of the matching procedure significantly affected the survival. In conclusion, the duration of the matching procedure in addition to the level of matching should be considered as an independent risk factor of survival.

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最佳配型和手术时间影响非亲属供体造血干细胞移植后患者的生存。
86名患有恶性血液病、免疫缺陷和再生障碍性贫血的患者接受了来自非亲属供体的同种异体造血干细胞移植。从BMDW文件中选择供体,并根据使用PCR SSP和基于测序的确认分型程序进行进一步匹配。从临床要求寻找供体到临床医生最终决定接受供体的时间为0.3 ~ 17.8个月(中位1.6个月)。在等位基因水平上进行配对分析,50对、27对和9对供体-受体分别有10/10的等位基因匹配、1个或多个等位基因不匹配。在单变量分析中,我们发现,如果患者接受移植:(i)供体匹配10/10 (P = 0.025), (ii)女性供体与男性供体不匹配(P = 0.037), (iii)怀孕≤1次的女性供体与多胎女性供体相比生存率更高(P = 0.075)。值得注意的是,确认型分型过程的持续时间明显影响生存率(HR = 1.138, P = 0.013)。在多变量分析中,只有匹配水平和匹配过程的持续时间显著影响生存率。总之,除匹配水平外,匹配过程的持续时间应被视为生存的独立危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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