Unrelated allogeneic stem-cell transplantation in adult patients – 10-year experience

Abstract

Objectives: Allogeneic stem-cell transplantation is an efficient treatment modality for adult patients with various leukemias. Due to the lack of family donors, stem-cell transplantation with unrelated HLA identical donors is on the increase. In the past, such transplantation was mostly performed for chronic myeloic leukemia. Today it is rarely used in this type of leukemia because of tyrosine kinase inhibitors, but it is becoming more popular for acute leukemias with unfavorable prognostic factors. Methods: Between the years 2002 and 2011, eighty-six patients mostly with acute leukemias were transplanted. The survival curves were calculated and both the impact of the type of disease on the treatment outcome and the change in indications after the introduction of new target drugs were estimated. Results: Estimated 10-year survival for patients with acute myeloblastic leukemia is around 35 %, and for patients with acute lymphoblastic leukemia around 25 %. Unrelated transplantation for chronic myeloic leukemia is now only rarely performed but the number of transplants for multiple myeloma and lymphomas is increasing. Conclusion: Unrelated allogeneic stem-cell transplantation is suitable for acute myeloblastic leukemias with unfavorable risk factors. However, results in acute lymphoblastic leukemia are worse. Unrelated transplantation is not efficient as salvage treatment for patients with recurrent disease after autologous transplantation or chemotherapy- resistant relapse.