Impact of donor telomere length on survival in patients undergoing matched sibling donor transplantation for aplastic anaemia.
Adolescent
Adult
Age Factors
Anemia, Aplastic
/ mortality
Child
Child, Preschool
Female
Graft Rejection
Graft Survival
Hematopoietic Stem Cell Transplantation
/ methods
Humans
Male
Middle Aged
Prognosis
Siblings
Telomere
/ genetics
Telomere Homeostasis
Tissue Donors
Transplantation Conditioning
/ methods
Treatment Outcome
Young Adult
aplastic anaemia
haematopoietic stem cell transplantation
matched sibling donor
overall survival
telomere length
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
revised:
01
09
2021
received:
12
07
2021
accepted:
22
09
2021
pubmed:
5
10
2021
medline:
15
2
2022
entrez:
4
10
2021
Statut:
ppublish
Résumé
Although telomere shortening is seen frequently in patients with aplastic anaemia (AA), there are no data on its association in matched sibling donor (MSD) transplants. We evaluated the effect of pre-transplant telomere length of patients and donors, measured by quantitative real-time polymerase chain reaction in 163 recipients undergoing MSD transplants. The median age of patients and donors was 24 and 26 years, respectively. Fludarabine and cyclophosphamide was the main conditioning regimen used and all received peripheral blood stem cell grafts. Engraftment occurred in 89% with graft failure (primary and secondary) in 6%. Acute and chronic graft-versus-host disease (GVHD) occurred in 28% and 24%, respectively. At a median follow-up of 37 months, 117 patients (72%) were alive. All patients and donors were divided into short and long telomere length based on their median and quartile values. Patient telomere length was not associated with severity of AA, neutrophil recovery, graft failure, acute GVHD or chronic GVHD. Longer donor telomere length was associated with better overall survival [hazard ratio (HR) = 0·2, P = 0·006] but did not influence neutrophil recovery, graft failure, acute or chronic GVHD. The five-year overall survival was significantly better (94·9 ± 3·5% vs 65·4 ± 4·3%, P = 0·002) for donors with long (highest quartile, DTL-HQ) versus short (lower three quartiles, DTL-LQ) telomeres, respectively. On multivariate analysis, longer donor telomere length, recipient age and acute GVHD continued to remain significant. This is the first study demonstrating an association of donor telomere length on overall survival following MSD transplant for AA but it needs to be confirmed in larger studies.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
724-734Informations de copyright
© 2021 British Society for Haematology and John Wiley & Sons Ltd.
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