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Marrow Transplants from Unrelated Donors for the Treatment of High-Risk Acute Leukemia

  • J. Sierra
  • J. W. Bjerke
  • J. A. Hansen
  • P. J. Martin
  • E. W. Petersdorf
  • C. Anasetti
Conference paper
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 39)

Abstract

Transplantation of allogeneic stem cells has become a well established treatment for a variety of hematological malignancies including poor-risk acute leukemias [1]. This procedure has the highest probability of success if donor and recipient are closely HLA-matched. For patients without a suitable relative, one option is to identify an HLA-identical unrelated volunteer donor [2]. Despite the enormous polymorphism of HLA genes, the probability of finding a compatible unrelated donor is increasing since the international registries contain now more than 3.5 million HLA-typed volunteers. Shortening the time needed for the donor search has made unrelated donor bone marrow transplants (URD-BMT) a realistic alternative for the treatment of patients with acute leukemia. Five-hundred ninety-five URD-BMT were facilitated by the U.S. National Marrow Donor Program (NMDP) for the treatment of acute leukemias between 1989 and 1993 [3].

Keywords

Acute Leukemia Acute GVHD Chronic GVHD Unrelated Donor National Marrow Donor Program 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Goldman JM (1996) Hematopoietic stem cell transplantation. Curr Opin Hematol; 3: 403–404CrossRefGoogle Scholar
  2. 2.
    Sierra J, Anasetti C. (1995) Marrow transplantation from unrelated donors. Curr Opin Hematol; 2: 444–451PubMedCrossRefGoogle Scholar
  3. 3.
    Beatty PG, Kollman C, Howe CWS (1996) Unrelated donor marrow transplants: the experience of the National Marrow Donor Program. Clinical Transplants 1995, Cecka and Terasaki, Eds. UCLA. Los Angeles, California, pp 271–277Google Scholar
  4. 4.
    Gratwohl A, Hermans J (1994) Bone marrow transplantation activity in Europe 1992: report from the European Group for Bone Marrow Transplantation. Bone Marrow Transplant 13: 510Google Scholar
  5. 5.
    Gratwohl A, Hermans J (1995) Indications and donor source of hematopoietic stem cell transplants in Europe 1993: report from the European Group for Blood and Marrow Transplantation. Clin Transplantation 9: 355–363Google Scholar
  6. 6.
    Gratwohl A, Hermans J, Baldomero H (1996) Hematopoietic precursor cell transplants in Europe: Activity in 1994. Report from the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 17: 137–148PubMedGoogle Scholar
  7. 7.
    Gratwohl A, Hermans J, Baldomero H (1997) Blood and marrow transplantation activity in Europe 1995. Bone Marrow Transplant 19: 407–419PubMedCrossRefGoogle Scholar
  8. 8.
    Busca A, Anasetti C, Anderson G, Appelbaum FR, Buckner CD, Doney K, Martin PJ, Petersdorf E, Sanders JE, Hansen JA (1994) Unrelated donor or autologous marrow transplantation for treatment of acute leukemia. Blood 83: 3077–3084PubMedGoogle Scholar
  9. 9.
    Petersdorf EW, Smith AG, Mickelson EM, Martin PJ, Hansen (1991) Ten HLA-DR4 alleles defined by sequence polymorphism within the DRB1 first domain. Immunogenetics 33: 267–275Google Scholar
  10. 10.
    Hansen JA, Mickelson EM, Choo SY, Petersdorf EW, Anasetti C, Martin PJ, Thomas ED (1992) Clinical bone marrow transplantation: donor selection and recipient monitoring, in Rose NR, De Macario EC, Fahey JL, Friedman H, Penn GM (eds), Manual of clinical laboratory immunology ( ed 4 ), Washington, DC, American Society for Microbiology, p 850–866Google Scholar
  11. 11.
    Dupont B, Yang SY. Histocompatibility, in Forman SJ, Blume KJ, Thomas ED (eds) (1994), Bone marrow transplantation. Boston, MA, Blackwell, p 22–40Google Scholar
  12. 12.
    Storb R, Deeg J, Pepe M, Appelbaum F, Anasetti C, Beatty PG, Bensinger W, Berenson R, Buckner CD, Clift RA, Doney K, Longton G, Hansen JA, Hill R, Loughran T, Martin PJ, Singer J, Sanders J, Stewart P, Sullivan K, Witherspoon R, Thomas ED (1989) Methotrexate and cyclosporine versus cyclosporine alone for prophylaxis of graftversus-host disease in patients given HLA-identical marrow grafts for leukemia: long-term follow-up of a controlled trial. Blood 73: 1729–1734PubMedGoogle Scholar
  13. 13.
    Przepiorka D, Weisdorf D, Martin P, Klinge-mann HG, Beatty P, Hows J, Thomas ED (1995) 1994 consensus conference on acute GVHD grading. Bone Marrow Transplant 15: 825–828Google Scholar
  14. 14.
    Doney KC, Weiden PL, Storb R, Thomas ED (1981) Treatment of graft-versus-host disease in human allogeneic marrow graft recipients: a randomized trial comparing antithymocyte globulin and corticosteroids. Am J Hematol 11: 1–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Anasetti C, Martin PJ, Storb R, Appelbaum FR, Beatty PG, Davis J, Doney K, Hill HF, Stewart P, Sullivan KM, Witherspoon RP, Thomas ED, Hansen JA (1992) Treatment of acute graft-versus-host disease with a nonmitogenic anti-CD3 monoclonal antibody. Transplantation 54: 844–851PubMedCrossRefGoogle Scholar
  16. 16.
    Anasetti C, Hansen JA, Waldmann TA, Appelbaum FR, Davis J, Deeg J, Doney K, Martin PJ, Nash R, Storb R, Sullivan KM, Witherspoon RP, Binger MH, Chizzonite R, Hakimi J, Mould D, Satoh H, Light S (1994) Treatment of acute graftversus-host disease with humanized anti-Tac. An antibody that binds to the interleukin-2 receptor. Blood 84: 1320–1327PubMedGoogle Scholar
  17. 17.
    Sullivan KM, Agura E, Anasetti C, Appelbaum F, Badger C, Bearman S, Erickson K, Flowers M, Hansen J, Loughran T, Matthews D, Petersdorf E, Radich J, Riddell S, Rovira D, Sanders J, Schuening F, Siadak M, Storb R, Witherspoon TP (1991) Chronic graft-versus-host disease and other late complications of bone marrow transplantation. Semin Hematol 28: 250–259PubMedGoogle Scholar
  18. 18.
    Sullivan KM, Shulman HM, Storb R, Weiden PL, Witherspoon RP, Mc Donald GB, Schubert MM, Atkinson K, Thomas ED (1981) Chronic graftversus-host disease in 52 patients.Adverse natural course and successful treatment with combination immunosuppression. Blood 52: 267–276Google Scholar
  19. 19.
    Kaplan EL, Meier P (1958) Nonparametric estimation for incomplete observations. J Am Stat Ass 53: 457–481CrossRefGoogle Scholar
  20. 20.
    Peto R, Pike MC, Armitage P et al. (1977) Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. Analysis and examples. Br J Cancer 35: 1–39PubMedCrossRefGoogle Scholar
  21. 21.
    Kalbfleish JD, Prentice RL (1980) The statistical analysis of failure time data. New York, NY, Wiley 1980Google Scholar
  22. 22.
    Nash RA, Pineiro LA, Storb R, Deeg HJ, Fitzsimmons WE, Furlong T, Hansen JA, Gooley T, Maher RM, Martin P, McSweeney PA, Sullivan KM, Ana-setti C, Fay JW (1996) FK506 in combination with methotrexate for the prevention of graft-versushost disease after marrow transplantation from matched unrelated donors. Blood 88: 3634–3641PubMedGoogle Scholar
  23. 23.
    Anasetti C, Lin A, Nademanee A, Gluckman E, Messner H, Beatty P, Chauncey T, Jacobsen N, Chao N, Powles R, Territo M, Walker I, Davis J, Light S (1995) A phase II/III randomized double-blind, placebo-controlled multicenter trial of humanized anti-Tac for prevention of acute graft-versus-host disease in recipients of marrow transplants from unrelated donors. Proceedings of the American Society of Hematology. Blood 86 (suppl 1): 621aGoogle Scholar
  24. 24.
    Schiller G, Feig SA, Territo M, Wolin M, Lill M, Belin T, Hunt L, Nimer S, Champlin S, Gajewski J (1994) Treatment of advanced acute leukemia with allogeneic bone marrow transplantation from unrelated donors. Br J Haematol 88: 72–78PubMedCrossRefGoogle Scholar
  25. 25.
    Casper J, Camitta B, Truitt R, Baxter-Lowe LA, Bunin N, Lawton C, Murray K, Hunter J, Pietryga D, Garbrecht F, Taylor CK, Drobyski W, Horowitz M, Flomenberg N, Ash R (1995) Unrelated bone marrow transplants for children with leukemia or myelodysplasia. Blood 9: 2354–2363Google Scholar
  26. 26.
    Oakhill A, Pamphilon DH, Potter MN, Steward CG, Goodman S, Green A, Goulden P, Goulden NJ, Hale G, Waldmann H, Cornish JMM (1996) Unrelated donor bone marrow transplantation for children with acute lymphoblastic leukemia in second complete remission. Br J Haematol 94: 574–578PubMedCrossRefGoogle Scholar
  27. 27.
    Kernan NA, Bartsch G, Ash R, Beatty PG, Champlin R, Filipovich A, Gajewski J, Hansen JA, Heslee-Downey J, McCullogh J, McGlave P, Perkins HA, Phillips GL, Sanders J, Stroncek D, Thomas ED, Blume KG (1993) Analysis of 462 transplantations from unrelated donors facilitated by the National Marrow Donor Program. N Engl J Med 328: 593–602PubMedCrossRefGoogle Scholar
  28. 28.
    Hoelzer D (1994) Treatment of acute lymphoblastic leukemia. Semin Hematol 31: 1–15PubMedGoogle Scholar
  29. 29.
    Miyamura K, Tanimoto M, Morishima Y, Horibe K, Yamamoto K, Akatsuka M, Kodera Y, Kojima S, Matsuyama K, Hirabayashi N, Yazaki M, Imai K, Onozawa Y, Kanamaru A, Mizutani S, Saito H (1992) Detection of Philadelphia chromosome-positive acute lymphoblastic leukemia by polymerase chain reaction. Possible eradication of minimal residual disease by marrow transplantation. Blood 79: 1366–1370PubMedGoogle Scholar
  30. 30.
    Stockschläder M, Hegewisch-Becker S, Krügeer W, tom Dieck A, Mross K, Hoffknecht M, Berger C, Kohlschütter B, Martin H, Peters S, Kabisch H, Kuse R, Weh H, Zander A (1995) Bone marrow transplantation for Philadelphia-chromosomepositive acute lymphoblastic leukemia. Bone Marrow Transplant 16: 663–667PubMedGoogle Scholar
  31. 31.
    Annino L, Ferrari A, Cedrone M, Giona F, Lo Coco F, Meloni G, Arcese W, Mandelli F (1994) Adult Philadelphia-chromosome-positive acute lymphoblastic leukemia. Experience of treatments during a ten-year period. Leukemia 8: 664–667Google Scholar
  32. 32.
    Preti HA, O’Brien S, Giralt S, Beran M, Pierce S, Kantarjian HM (1994) Philadelphia-chromosome-positive adult acute lymphocytic leukemia: characteristics, treatment results, and prognosis in 41 patients. Am J Med 97: 60–65PubMedCrossRefGoogle Scholar
  33. 33.
    Brennan C, Weisdorf D, Kersey J, Haake R, Ramsay N (1991) Bone marrow transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. Proc Am Soc Clin Oncol 10: 222Google Scholar
  34. 34.
    Powles R, Mehta J, Singhal S, Horton C, Tait D, Milan S, Pollard C, Lumley H, Matthey F, Shirley J, Williams H, Samaratunga I, Lakhani A, Millar J, Treleaven J (1995) Autologous bone marrow or peripheral blood stem cell transplantation followed by maintenance chemotherapy for adult acute lymphoblastic leukemia in first remission: 50 cases from a single center. Bone Marrow Transplant 16: 241–247PubMedGoogle Scholar
  35. 35.
    Forman SJ, O’Donell MR, Nademanee AP, Snyd DS, Bierman PJ, Schmidt GM, Fahey JL, Stein AS, Parker PM, Blume KG (1987) Bone marrow transplantation for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood 70: 587–588PubMedGoogle Scholar
  36. 36.
    Barret AJ, Horowitz MM, Ash RC, Atkinson K, Gale RP, Goldman JM, Henslee-Downey PJ, Herzig RH, Speck B, Zwaan FE, Bortin MM (1992) Bone marrow transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood 79: 3067–3070Google Scholar
  37. 37.
    Hessner MJ, Endean DJ, Casper JT, Horowitz MM, Keever-Taylor CA, Roth M, Flomenberg N, Drobyski WR (1995) Use of unrelated marrow grafts compensates for reduced graft-versus-leukemia reactivity after T-cell-depleted allogeneic marrow transplantation for chronic myelogenous leukemia. Blood 86: 3987–3996PubMedGoogle Scholar
  38. 38.
    Beatty PG, Anasetti P, Hansen JA, Longton GM, Sanders JE, Martin PJ, Mickelson EM, Choo SY, Petersdorf EW, Pepe MS et al. (1993) Marrow transplantation from unrelated donors for treatment of hematologic malignancies: effect of mismatching for one locus. Bone Marrow Transplant 81: 249–253Google Scholar
  39. 39.
    Nademanee A, Schmidt GM, Parker P, Dagis AC, Stein A, Snyder DS, O’Donell M, Smith EP, Stepan DE, Molina A, Wong KK, Margolin K, Somlo G, Littrell B, Woo D, Sniecinski I, Niland JC, Forman SJ (1995) The outcome of matched unrelated donor bone marrow transplantation in patients with hematologic malignancies using molecular typing for donor selection and graftversus-host disease prophylaxis regimen of cyclosporine, methotrexate, and prednisone. Blood 86: 1228–1234PubMedGoogle Scholar
  40. 40.
    Speiser DE, Tiercy JM, Rufer N, Grundschober C, Gratwohl A, Chapuis B, Helg C, Löliger CC, Siren MK, Roosnek E, Jeannet M (1996) High resolution HLA matching associated with decreased mortality after unrelated bone marrow transplantation. Blood 87: 4455–4462PubMedGoogle Scholar
  41. 41.
    Grovas A, Feig SA, O’Rourke S, Valentino L, Wiley F, Hunt L, Landaw EM, Gajewski J (1995) Unrelated donor bone marrow transplants in children. Cell Transplantation 3: 413–420Google Scholar
  42. 42.
    Balduzzi A, Gooley T, Anasetti C, Sanders J, Martin PJ, Petersdorf EW, Appelbaum FR, Buckner CD, Matthews D, Storb R, Sullivan KM, Hansen JA (1995) Unrelated donor marrow transplantation in children. Blood 86: 3247–3256PubMedGoogle Scholar
  43. 43.
    Goldman JM (1994) for the World Marrow Donor Association executive committee. Bone marrow transplants using volunteer donors. Recommendations and requirements for a standardized practice throughout the world. 1994 update. Blood 84: 2833–2839Google Scholar
  44. 44.
    Schimtz N, Gratwohl A, Goldman JM (1996) Allogeneic and autologous transplantation for haematological diseases, solid tumours and immune disorders. Current practice in Europe in 1996 and proposals for an operational classification. Bone Marrow Transplant 17: 471–477Google Scholar
  45. 45.
    Storb R, Prentice RL, Thomas ED (1977) Marrow transplantation for treatment of aplastic anemia. N Engl J Med 296: 61–66PubMedCrossRefGoogle Scholar
  46. 46.
    Storb R, Prentice RL, Thomas ED, Appelbaum FR, Deeg HJ, Doney K, Fefer A, Goodell BW, Mickelson E, Stewart P, Sullivan KM, Whither-spoon RP (1983) Factors associated with graft rejection after HLA-identical marrow transplantation for aplastic anaemia. Br J Haematol 55: 573–585PubMedCrossRefGoogle Scholar
  47. 47.
    Deeg HJ, Self S, Storb R, Doney K, Appelbaum FR, Witherspoon RP, Sullivan KM, Sheehan K, Sanders J, Mickelson E, Thomas ED (1986) Decreased incidence of marrow graft rejection in patients with severe aplastic anemia. Changing impact of risk factors. Blood 68: 1363–1368PubMedGoogle Scholar
  48. 48.
    Sanders JE, Whitehead J, Storb R, Buckner CD, Clift RA, Mickelson E, Appelbaum FR, Bensinger WI, Stewart P, Doney K, Sullivan K, Deeg HJ, Witherspoon RP, Thomas ED (1986) Bone marrow transplantation experience for children with aplastic anemia. Pediatrics 77: 179–186PubMedGoogle Scholar
  49. 49.
    Niederwieser D, Pepe M, Storb R, Loughran TP, Longton G (1988) Improvement in rejection, engraftment rate and survival without increase in graft-versus-host disease by high marrow cell dose in patients transplanted for aplastic anaemia. Br J Haematol 69: 23–28PubMedCrossRefGoogle Scholar
  50. 50.
    Petersdorf EW, Longton GM, Anasetti C, Mickel-son EM, McKinney SK, Smith AG, Martin PJ, Hansen JA (1997) Association of HLA-C disparity with graft failure after marrow transplantation from unrelated donors. Blood 89: 18181823Google Scholar
  51. 51.
    Bortin MM, Gale RP, Kay HEM, Rimm AA (1983) Bone marrow transplantation for acute myelogenous leukemia. Factors associated with early mortality. JAMA 249: 1166–1175PubMedCrossRefGoogle Scholar
  52. 52.
    Clift RA, Buckner CD, Thomas ED, Kopecky KJ, Appelbaum FR, Tallman M, Storb R, Sanders J, Sullivan K, Banaji M, Beatty PS, Bensinger W, Cheever M, Deeg J, Doney K, Fefer A, Greenberg P, Hansen JA, Hackman R, Hill R, Martin P, Meyers J, McGuffin R, Neiman P, Sale G, Shulman H, Singer J, Stewart P, Weiden P, Witherspoon R (1987) The treatment of acute-non-lymphoblastic leukemia by allogeneic marrow transplantation. Bone Marrow Transplant 2: 243–258PubMedGoogle Scholar
  53. 53.
    Mavroudis D, Read E, Cottler-Fox, Couriel D, Molldrem J, Carter C, Yu M, Dunbar C, Barrett J (1996) CD34+ cell dose predicts survival, post-transplant morbidity, and rate of hematologic recovery after allogeneic marrow transplants for hematologic malignancies. Blood 88: 3223–3229PubMedGoogle Scholar
  54. 54.
    Sprent J, Schaefer M, Korngold R (1990) Role of T-cell subsets in lethal graft-versus-host disease directed to class I versus class II H-2 differences. Protective effects of L3T4+ cells in anti-class II H-2 differences. J. Immunol 144: 2946–2954PubMedGoogle Scholar
  55. 55.
    Anasetti C, Anderson G, Appelbaum FR, Buckner CD, Martin PJ, Nemunaitis J, Singer J, Storb R, Sullivan KM, Thomas ED, Hansen JA (1993) Phase III study of rhGM-CSF in allogeneic marrow transplantation from unrelated donors. Proceedings at the American Society of Hematology. Blood 82: 454Google Scholar
  56. 56.
    Heynes AP, Russell NH (1995) Blood stem cell allografting. Curr Opin Hematol 2: 431–435CrossRefGoogle Scholar
  57. 57.
    Bensinger WI, Weaver CH, Appelbaum FR, Rowley S, Demirer T, Sanders J, Storb R, Buckner CD (1995) Transplantation of allogeneic peripheral blood stem cells mobilized by recombinant human granulocyte colony-stimulating factor. Blood 85: 1655–1658PubMedGoogle Scholar
  58. 58.
    Körbling M, Przepiorka D, Huh YO, Engel H, van Besien K, Giralt S, Andersson B, Kleine HD; Seong D, Deisseroth AB, Andreeff M, Champlin R (1995) Allogeneic blood stem cell transplantation for refractory leukemia and lymphoma: potential advantage of blood over marrow allo-grafts. Blood 85: 1659–1665PubMedGoogle Scholar
  59. 59.
    Schmitz N, Dreger P, Suttorp M, Rohwedder EB, Haferlach T, Löffler H, Hunter A, Russell NH (1995) Primary transplantation of allogeneic peripheral blood progenitor cells mobilized by filgrastim (granulocyte colony-stimulating factor). Blood 85: 1666–1672PubMedGoogle Scholar
  60. 60.
    Ottinger HD, Beelen DW, Scheulen B, Schaefer UW, Grosse-Wilde H (1996) Improved immune reconstitution after allotransplantation of peripheral blood stem cells instead of bone marrow. Blood 88: 2775–2779PubMedGoogle Scholar
  61. 61.
    Bensinger WI, Clift R, Martin P, Appelbaum FR, Demirer T, Gooley T, Lilleby K, Rowley S, Sanders J, Storb R, Buckner CD (1996) Allogeneic peripheral blood stem cell transplantation in patients with advanced hematologic malignancies: a retrospective comparison with marrow transplantation. Blood 88: 2794–2800PubMedGoogle Scholar
  62. 62.
    Ringdén O, Potter MN, Oakhill A, Cornish J, Hägglund H, Lönnqvist B, Shanwell A, Winiarski J, Pamphilon DH (1996) Transplantation of peripheral blood progenitor cells from unrelated donors. Bone Marrow Transplant 17 (suppl 2): S62 - S64PubMedGoogle Scholar
  63. 63.
    Majolino Y, Saglio G, Scime R, Serra A, Cavallero AM, Fiandaca T, Vasta S, Pampinella M, Catania P, Indovina A, Marceno R, Santoro A (1996) High incidence of chronic GVHD after primary allogeneic peripheral blood stem cell transplantation in patients with hematologic malignancies. Bone Marrow Transplant 17: 555–560PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • J. Sierra
    • 1
  • J. W. Bjerke
    • 2
  • J. A. Hansen
    • 2
    • 3
  • P. J. Martin
    • 2
    • 3
  • E. W. Petersdorf
    • 2
    • 3
  • C. Anasetti
    • 2
    • 3
  1. 1.Hematology Department, Hospital ClinicUniversity of BarcelonaBarcelonaSpain
  2. 2.Fred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.University of WashingtonSeattleUSA

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