Donor and Recipient Individual Factors as Predictive Markers of Overall Survival After Allogeneic Hematopoietic Stem Cell Transplantation; Dream or Reality
-
Pooya Eslampour
,
Sayeh Parkhideh
,
Mahshid Mehdizadeh
,
Samira Karami
,
Elham Roshandel
,
Hossein Bonakchi
,
Abbas Hajifathali
Abstract
Low overall survival (OS) still is a major concern of allogeneic hematopoietic stem cell transplantation (allo-HSCT), which is affected by many individual and environmental factors. In this study, we retrospectively evaluated the association of donor and recipient individual factors with the overall survival of 206 patients who underwent allo-HSCT. Donor and recipient prognostic factors consisted of donor and recipient age, donor-recipient gender status, recipient body mass index (BMI), underlying disease, recipient cytomegalovirus (CMV) serostatus, and time from diagnosis to transplant (DTT) were included in the overall survival analysis. In univariable analysis, recipient age, donor-recipient gender status, underlying disease, recipient CMV serostatus, and DTT were significantly associated with the OS. The hazard of death in patients with DTT less than 14 months was 38% lower than those with a DTT higher than 14 months (P=0.06). Multivariate analysis showed that patients with aplastic anemia (HR=3.58; P=0.11) and Hodgkin’s disease (HR=3.89; P=0.11) have a much lower survival than unclassified diseases. Moreover, patients with acute myeloid leukemia and acute lymphoblastic leukemia showed better outcomes compared to the unclassified group. The donor and patient characteristics such as age, CMV serostatus, underlying disease, and time from diagnosis to transplantation could influence the overall survival of patients after allo-HSCT.
1. Baumgartner A, Hoskin K, Schuetz P. Optimization of nutrition during allogeneic hematologic stem cell transplantation. Curr Opin Clin Nutr Metab Care 2018;21:152-8.
2. Anasetti C. What are the most important donor and recipient factors affecting the outcome of related and unrelated allogeneic transplantation? Best Pract Res Clin Haematol 2008;21:691-7.
3. Fuji S, Takano K, Mori T, Eto T, Taniguchi S, Ohashi K, et al. Impact of pretransplant body mass index on the clinical outcome after allogeneic hematopoi SCT. Bone Marrow Transplant 2014;49:1505-12.
4. Rezvani AR, Storer BE, Guthrie KA, Schoch HG, Maloney DG, Sandmaier BM, et al. Impact of donor age on outcome after allogeneic hematopoietic cell transplantation. Biology of blood and marrow transplantation: Biol Blood Marrow Transplant 2015;21:105-12.
5. Yang J, Xue SL, Zhang X, Zhou YN, Qin LQ, Shen YP, et al. Effect of body mass index on overall survival of patients with allogeneic hematopoietic stem cell transplantation. Eur J Clin Nutr 2017;71:750-4.
6. Kollman C, Howe CW, Anasetti C, Antin JH, Davies SM, Filipovich AH, et al. Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age. Blood 2001;98:2043-51.
7. Davies SM, Kollman C, Anasetti C, Antin JH, Gajewski J, Casper JT, et al. Engraftment and survival after unrelated-donor bone marrow transplantation: a report from the national marrow donor program. Blood 2000;96:4096-102.
8. Sucak GT, Suyanı E, Baysal NA, Altındal Ş, Çakar MK, Akı ŞZ, et al. The role of body mass index and other body composition parameters in early post-transplant complications in patients undergoing allogeneic stem cell transplantation with busulfan–cyclophosphamide conditioning. Int J Hematol 2012;95:95-101.
9. Ando T, Yamazaki E, Ogusa E, Ishii Y, Yamamoto W, Motohashi K, et al. Body mass index is a prognostic factor in adult patients with acute myeloid leukemia. Int J Hematol 2017;105:623-30.
10. Ghavamzadeh A, Alimoghaddam K, Ghaffari F, Derakhshandeh R, Jalali A, Jahani M. Twenty years of experience on stem cell transplantation in Iran. Iran Red Crescent Med J 2013;15:93-100.
11. Vaezi M, Kasaeian A, Souri M, Soufiyan F, Boosjin AS, Setarehdan SA, et al. How Do Donor-Recipient CMV Serostatus and Post-Hematopoietic Stem Cell Transplantation CMV Reactivation Affect Outcomes in Acute Leukemia Patients? Int J Hematol Oncol Stem Cell Res 2017;11:199-208.
12. Gratwohl A, Stern M, Brand R, Apperley J, Baldomero H, de Witte T, et al. Risk score for outcome after allogeneic hematopoietic stem cell transplantation: a retrospective analysis. Cancer 2009;115:4715-26.
13. Fonseca-Hial AMR, Parisio K, Oliveira JSR. Allogeneic hematopoietic stem cell transplantation in patients with advanced indolent lymphoproliferative disorders. Rev Bras Hematol Hemoter 2016;38:99-105.
14. Onida F, de Wreede LC, van Biezen A, Eikema DJ, Byrne JL, Iori AP, et al. Allogeneic stem cell transplantation in patients with atypical chronic myeloid leukemia: a retrospective study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation. Br J Haematol 2017;177:759-65.
15. Salvatore D, Labopin M, Ruggeri A, Battipaglia G, Ghavamzadeh A, Ciceri F, et al. Outcomes of hematopoietic stem cell transplantation from unmanipulated haploidentical versus matched sibling donor in patients with acute myeloid leukemia in first complete remission with intermediate or high-risk cytogenetics: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica 2018;103:1317-28.
16. Schmidt-Hieber M, Labopin M, Beelen D, Volin L, Ehninger G, Finke J, et al. CMV serostatus has still an important prognostic impact in de novo acute leukemia patients after allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT. Blood 2013:122:3359-64.
17. Inagaki J, Noguchi M, Kurauchi K, Tanioka S, Fukano R, Okamura J. Effect of cytomegalovirus reactivation on relapse after allogeneic hematopoietic stem cell transplantation in pediatric acute leukemia. Biol Blood Marrow Transplant 2016;22:300-6.
18. Broers AE, van der Holt R, van Esser JW, Gratama J-W, Henzen-Logmans S, Kuenen-Boumeester V, et al. Increased transplant-related morbidity and mortality in CMV-seropositive patients despite highly effective prevention of CMV disease after allogeneic T-cell–depleted stem cell transplantation. Blood 2000;95:2240-5.
19. Apperley J, Dowding C, Hibbin J, Buiter J, Matutes E, Sissons P, et al. The effect of cytomegalovirus on hemopoiesis: in vitro evidence for selective infection of marrow stromal cells. Exp Hematol 1989;17:38-45.
20. Reddehase M, Dreher-Stumpp L, Angele P, Balthesen M, Šuša M. Hematopoietic stem cell deficiency resulting from cytomegalovirus infection of bone marrow stroma. Ann Hematol 1992;64:A125-7.
21. Torok-Storb B, Simmons P, Khaira D, Stachel D, Myerson D. Cytomegalovirus and marrow function. Ann Hematol 1992;64:A128-31.
22. Giebel S, Maccario R, Lilleri D, Zecca M, Avanzini M, Marconi M, et al. The immunosuppressive effect of human cytomegalovirus infection in recipients of allogeneic hematopoietic stem cell transplantation. Bone Marrow transplant 2005;36:503-9.
23. Kim HT, Zhang M-J, Woolfrey AE, Martin AS, Chen J, Saber W, et al. Donor and recipient sex in allogeneic stem cell transplantation: what really matters. Haematologica 2016;101:1260-6.
24. Le Blanc K, Ringdén O, Remberger M. A low body mass index is correlated with poor survival after allogeneic stem cell transplantation. Haematologica 2003;88:1044-52.
25. Xue S, Yang J, Zhang X, Shen Y, Depei W. Effect of body mass index on overall survival of patients with allogeneic hematopoietic stem cell transplantation. Blood 2015;126:5510.
26. Ren G, Cai W, Wang L, Huang J, Yi S, Lu L, et al. Impact of body mass index at different transplantation stages on postoperative outcomes in patients with hematological malignancies: a meta-analysis. Bone Marrow Transplant 2018;53:708-21.
27. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013;309:71-82.
28. van der Meij BS, de Graaf P, Wierdsma NJ, Langius JA, Janssen JJ, van Leeuwen PA et al. Nutritional support in patients with GVHD of the digestive tract: state of the art. Bone Marrow Transplant 2013;48:474-82.
29. Johnson-Davis KL, McMillin GA, Juenke JM, Ford CD, Petersen FB. Which dose of busulfan is best? Clin Chem 2010 1;56:1061-4.
30. Yañez R, Lamana ML, García-Castro J, Colmenero I, Ramírez M, Bueren JA. Adipose tissue-derived mesenchymal stem cells have in vivo immunosuppressive properties applicable for the control of the graft-versus-host disease. Stem Cells 2006;24:2582-91.
31. Young NS. Aplastic anemia. N Engl J Med 2018;379:1643-56.
32. Barras M, Legg A. Drug dosing in obese adults. Aust Prescr 2017;40:189-93.
2. Anasetti C. What are the most important donor and recipient factors affecting the outcome of related and unrelated allogeneic transplantation? Best Pract Res Clin Haematol 2008;21:691-7.
3. Fuji S, Takano K, Mori T, Eto T, Taniguchi S, Ohashi K, et al. Impact of pretransplant body mass index on the clinical outcome after allogeneic hematopoi SCT. Bone Marrow Transplant 2014;49:1505-12.
4. Rezvani AR, Storer BE, Guthrie KA, Schoch HG, Maloney DG, Sandmaier BM, et al. Impact of donor age on outcome after allogeneic hematopoietic cell transplantation. Biology of blood and marrow transplantation: Biol Blood Marrow Transplant 2015;21:105-12.
5. Yang J, Xue SL, Zhang X, Zhou YN, Qin LQ, Shen YP, et al. Effect of body mass index on overall survival of patients with allogeneic hematopoietic stem cell transplantation. Eur J Clin Nutr 2017;71:750-4.
6. Kollman C, Howe CW, Anasetti C, Antin JH, Davies SM, Filipovich AH, et al. Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age. Blood 2001;98:2043-51.
7. Davies SM, Kollman C, Anasetti C, Antin JH, Gajewski J, Casper JT, et al. Engraftment and survival after unrelated-donor bone marrow transplantation: a report from the national marrow donor program. Blood 2000;96:4096-102.
8. Sucak GT, Suyanı E, Baysal NA, Altındal Ş, Çakar MK, Akı ŞZ, et al. The role of body mass index and other body composition parameters in early post-transplant complications in patients undergoing allogeneic stem cell transplantation with busulfan–cyclophosphamide conditioning. Int J Hematol 2012;95:95-101.
9. Ando T, Yamazaki E, Ogusa E, Ishii Y, Yamamoto W, Motohashi K, et al. Body mass index is a prognostic factor in adult patients with acute myeloid leukemia. Int J Hematol 2017;105:623-30.
10. Ghavamzadeh A, Alimoghaddam K, Ghaffari F, Derakhshandeh R, Jalali A, Jahani M. Twenty years of experience on stem cell transplantation in Iran. Iran Red Crescent Med J 2013;15:93-100.
11. Vaezi M, Kasaeian A, Souri M, Soufiyan F, Boosjin AS, Setarehdan SA, et al. How Do Donor-Recipient CMV Serostatus and Post-Hematopoietic Stem Cell Transplantation CMV Reactivation Affect Outcomes in Acute Leukemia Patients? Int J Hematol Oncol Stem Cell Res 2017;11:199-208.
12. Gratwohl A, Stern M, Brand R, Apperley J, Baldomero H, de Witte T, et al. Risk score for outcome after allogeneic hematopoietic stem cell transplantation: a retrospective analysis. Cancer 2009;115:4715-26.
13. Fonseca-Hial AMR, Parisio K, Oliveira JSR. Allogeneic hematopoietic stem cell transplantation in patients with advanced indolent lymphoproliferative disorders. Rev Bras Hematol Hemoter 2016;38:99-105.
14. Onida F, de Wreede LC, van Biezen A, Eikema DJ, Byrne JL, Iori AP, et al. Allogeneic stem cell transplantation in patients with atypical chronic myeloid leukemia: a retrospective study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation. Br J Haematol 2017;177:759-65.
15. Salvatore D, Labopin M, Ruggeri A, Battipaglia G, Ghavamzadeh A, Ciceri F, et al. Outcomes of hematopoietic stem cell transplantation from unmanipulated haploidentical versus matched sibling donor in patients with acute myeloid leukemia in first complete remission with intermediate or high-risk cytogenetics: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica 2018;103:1317-28.
16. Schmidt-Hieber M, Labopin M, Beelen D, Volin L, Ehninger G, Finke J, et al. CMV serostatus has still an important prognostic impact in de novo acute leukemia patients after allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT. Blood 2013:122:3359-64.
17. Inagaki J, Noguchi M, Kurauchi K, Tanioka S, Fukano R, Okamura J. Effect of cytomegalovirus reactivation on relapse after allogeneic hematopoietic stem cell transplantation in pediatric acute leukemia. Biol Blood Marrow Transplant 2016;22:300-6.
18. Broers AE, van der Holt R, van Esser JW, Gratama J-W, Henzen-Logmans S, Kuenen-Boumeester V, et al. Increased transplant-related morbidity and mortality in CMV-seropositive patients despite highly effective prevention of CMV disease after allogeneic T-cell–depleted stem cell transplantation. Blood 2000;95:2240-5.
19. Apperley J, Dowding C, Hibbin J, Buiter J, Matutes E, Sissons P, et al. The effect of cytomegalovirus on hemopoiesis: in vitro evidence for selective infection of marrow stromal cells. Exp Hematol 1989;17:38-45.
20. Reddehase M, Dreher-Stumpp L, Angele P, Balthesen M, Šuša M. Hematopoietic stem cell deficiency resulting from cytomegalovirus infection of bone marrow stroma. Ann Hematol 1992;64:A125-7.
21. Torok-Storb B, Simmons P, Khaira D, Stachel D, Myerson D. Cytomegalovirus and marrow function. Ann Hematol 1992;64:A128-31.
22. Giebel S, Maccario R, Lilleri D, Zecca M, Avanzini M, Marconi M, et al. The immunosuppressive effect of human cytomegalovirus infection in recipients of allogeneic hematopoietic stem cell transplantation. Bone Marrow transplant 2005;36:503-9.
23. Kim HT, Zhang M-J, Woolfrey AE, Martin AS, Chen J, Saber W, et al. Donor and recipient sex in allogeneic stem cell transplantation: what really matters. Haematologica 2016;101:1260-6.
24. Le Blanc K, Ringdén O, Remberger M. A low body mass index is correlated with poor survival after allogeneic stem cell transplantation. Haematologica 2003;88:1044-52.
25. Xue S, Yang J, Zhang X, Shen Y, Depei W. Effect of body mass index on overall survival of patients with allogeneic hematopoietic stem cell transplantation. Blood 2015;126:5510.
26. Ren G, Cai W, Wang L, Huang J, Yi S, Lu L, et al. Impact of body mass index at different transplantation stages on postoperative outcomes in patients with hematological malignancies: a meta-analysis. Bone Marrow Transplant 2018;53:708-21.
27. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013;309:71-82.
28. van der Meij BS, de Graaf P, Wierdsma NJ, Langius JA, Janssen JJ, van Leeuwen PA et al. Nutritional support in patients with GVHD of the digestive tract: state of the art. Bone Marrow Transplant 2013;48:474-82.
29. Johnson-Davis KL, McMillin GA, Juenke JM, Ford CD, Petersen FB. Which dose of busulfan is best? Clin Chem 2010 1;56:1061-4.
30. Yañez R, Lamana ML, García-Castro J, Colmenero I, Ramírez M, Bueren JA. Adipose tissue-derived mesenchymal stem cells have in vivo immunosuppressive properties applicable for the control of the graft-versus-host disease. Stem Cells 2006;24:2582-91.
31. Young NS. Aplastic anemia. N Engl J Med 2018;379:1643-56.
32. Barras M, Legg A. Drug dosing in obese adults. Aust Prescr 2017;40:189-93.
| Files | ||
| Issue | Vol 59, No 1 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v59i1.5400 | |
| Keywords | ||
| Individual factors Allogeneic hematopoietic stem cell transplantation (allo-HSCT) Overall survival | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Eslampour P, Parkhideh S, Mehdizadeh M, Karami S, Roshandel E, Bonakchi H, Hajifathali A. Donor and Recipient Individual Factors as Predictive Markers of Overall Survival After Allogeneic Hematopoietic Stem Cell Transplantation; Dream or Reality. Acta Med Iran. 2021;59(1):28-36.
