Department of Internal Medicine, American University Beirut Medical Center, Beirut, Lebanon.
Bone Marrow Transplant. 2013 Aug;48(8):1065-9. doi: 10.1038/bmt.2013.1. Epub 2013 Jan 28.
Allogeneic hematopoietic cell transplantation (HCT) activity significantly increased in the Eastern Mediterranean area over the past decade. However, comparative outcomes with longer established centers, especially European Blood and Marrow Transplantation (EBMT) centers, have not been reported. We compared outcomes of matched-sibling allogeneic HCT between East Mediterranean Blood and Marrow Transplantation (EMBMT) and EBMT centers for adult patients with AML in first CR using myeloablative conditioning. We matched 431 patients from EMBMT with 431 patients from EBMT centers according to patient, disease and transplant characteristics. EMBMT recipients and donors were more likely to be CMV seropositive. There were no significant differences in the incidence of acute or chronic GVHD, or the 3-year cumulative incidence of non-relapse mortality (NRM) and relapse incidence (RI) between the two groups (NRM: EMBMT=16% vs EBMT=11), (RI: EMBMT=13% vs EBMT=19%). Notably, the 3-year leukemia-free survival (LFS) and OS were similar between the groups (LFS: EMBMT=70±2% vs EBMT=69±3%), (OS: EMBMT=74±2% vs EBMT=73±2%). Despite differences in socioeconomics, health resources and transplant experience, matched-sibling allogeneic HCT outcomes in emerging centers in the EMBMT region appear similar to EBMT centers.
过去十年中,东地中海地区异基因造血细胞移植(HCT)的活跃度显著增加。然而,与更成熟的中心(尤其是欧洲血液和骨髓移植协会(EBMT)中心)的比较结果尚未报道。我们比较了采用清髓性预处理的初诊完全缓解成人 AML 患者中,来自东地中海血液和骨髓移植协会(EMBMT)和 EBMT 中心的同胞供者异基因 HCT 的结局。我们根据患者、疾病和移植特征,将 EMBMT 的 431 例患者与 EBMT 中心的 431 例患者进行匹配。EMBMT 的受者和供者更有可能为 CMV 血清阳性。两组之间急性或慢性移植物抗宿主病的发生率,或 3 年非复发死亡率(NRM)和复发率(RI)的累积发生率均无显著差异(NRM:EMBMT=16% vs EBMT=11%),(RI:EMBMT=13% vs EBMT=19%)。值得注意的是,两组之间 3 年无白血病生存(LFS)和总生存(OS)相似(LFS:EMBMT=70±2% vs EBMT=69±3%),(OS:EMBMT=74±2% vs EBMT=73±2%)。尽管在社会经济学、卫生资源和移植经验方面存在差异,但 EMBMT 地区新兴中心的同胞供者异基因 HCT 结局似乎与 EBMT 中心相似。