Risk factors and outcome of graft failure after HLA matched and mismatched unrelated donor hematopoietic stem cell transplantation: a study on behalf of SFGM-TC and SFHI. - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Bone Marrow Transplantation Année : 2016

Risk factors and outcome of graft failure after HLA matched and mismatched unrelated donor hematopoietic stem cell transplantation: a study on behalf of SFGM-TC and SFHI.

Jason Lambert
K Dessaux
  • Fonction : Auteur
Pascal Perrier
  • Fonction : Auteur
A Ramounau-Pigot
  • Fonction : Auteur
R Peffault de La Tour
  • Fonction : Auteur

Résumé

Graft failure remains a severe complication of hematopoietic stem cell transplantation (HSCT). Several risk factors have already been published. In this study, we re-evaluated them in a large cohort who had the benefit of the recent experience in HSCT (2006–2012). Data from 4684 unrelated donor HSCT from 2006 to 2012 were retrospectively collected from centers belonging to the French Society for Stem Cell Transplantation. Among the 2716 patients for whom HLA typing was available, 103 did not engraft leading to a low rate of no engraftment at 3.8%. In univariate analysis, only type of disease and status of disease at transplant for malignant diseases remained significant risk factors (P = 0.04 and Po0.0001, respectively). In multivariate analysis, only status of disease was a significant risk factor (Po0.0001). Among the 61 patients who did not engraft and who were mismatched for 1 HLA class I and/or HLA-DP, 5 donor-specific antibodies (DSAs) were detected but only 1 was clearly involved in graft failure, for the others their role was more questionable. Second HSCT exhibited a protective although not statistically significant effect on OS (hazard ratio = 0.57 [0.32–1.02]). In conclusion, only one parameter (disease status before graft) remains risk factor for graft failure in this recent cohort.

Dates et versions

hal-01279037 , version 1 (25-02-2016)

Identifiants

Citer

Thomas Cluzeau, Jason Lambert, N Raus, K Dessaux, L Absi, et al.. Risk factors and outcome of graft failure after HLA matched and mismatched unrelated donor hematopoietic stem cell transplantation: a study on behalf of SFGM-TC and SFHI.. Bone Marrow Transplantation, 2016, ⟨10.1038/bmt.2015.351⟩. ⟨hal-01279037⟩
485 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More