In a nutshell
This study aimed to compare the outcomes of different cell sources for stem cell transfers used to treat acute myeloid leukemia patients.
This study concluded that familial-mismatched donors are a good option if matched sibling donors are not available.
Acute myeloid leukemia (AML) occurs when abnormal myeloblasts are produced. Myeloblasts are a type of white blood cell that produce other cells. Abnormal myeloblasts cannot produce healthy cells. Lack of healthy cells can lead to a weak immune system, infection and bleeding.
A hematopoietic stem cell transplant (HSCT) is the standard treatment option for AML. It involves taking stem cells from a donor and putting them into the AML patient. Stem cells can produce any cell type and help to restore the immune system. Stem cells come from different sources. Autologous (AUTO-HSCT) means the cells come from the patient’s own body. Allogenic (ALLO-HSCT) means the cells come from a donor. The donor may be a matched sibling donor (MSD) or a well matched unrelated donor (WM-URD). If none of these options are available, then a partially matched unrelated donor (PM-URD) or a familial-mismatched donor (FMMD) may be used.
It was not known what effect the source of cells had on the outcomes of HSCT for patients with AML.
Methods & findings
This study involved 561 patients with AML who were intermediate to high-risk based on genetic abnormalities who underwent HSCT. Patients who underwent HSCT received stem cells from different sources. Various outcomes were measured.
Disease free survival (DFS) at 5 years was 61.4% for the MSD group, 62.1% for the WM-URD group and 65.3% for the FMMD group.
DFS at 5 years was 44.7% for the AUTO group and 36.8% for the PM-URD group.
The relapse rate (chance of cancer returning) for the AUTO group was 51% compared to 23.5% for the MSD group and 18.5% for the FMMD group.
The lowest 5-year non-relapse mortality (NRM, death that occurs due to causes other than relapse) rate was 3.8% for the AUTO group compared to 29.3% for PM-URD group which was the highest. The 5 year NRM for WM-URD was 7.4%, for FMMT was 15.7% and for MSD was 15.6%.
The bottom line
This study concluded that FMMD is a good option for HSCT if MSD is not available.
The fine print
Studies of longer duration need to be carried out.
Consult your physician about which different sources of stem cells for HSCT.
Published By :
Jun 19, 2017