DÄ internationalArchive6/2009Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia: In reply

Correspondence

Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia: In reply

Dtsch Arztebl Int 2009; 106(6): 98. DOI: 10.3238/arztebl.2008.0098b

Zander, A R; Bacher, U; Finke, J

LNSLNS Herrmann-Frank et al. doubt that transplantation of HLA identical unrelated donors is equivalent to sibling donor transplantation. Since for most AML patients no HLA identical related donor is available, but an HLA identical unrelated donor may be found, this is indeed important.

The study by Mothy et al that is cited by Herrmann-Frank, on the comparison of dose reduced conditioning if a HLA identical family donor is available with standard or high dose chemotherapy if none is available shows unequivocally the superiority of family donor transplantation vis-à-vis other, non-transplantation, strategies in AML. Several larger studies confirmed the equivalence of HLA identical unrelated donor transplantation versus family donor transplantation in AML. An analysis of HLA identical unrelated donor transplantation versus family donor transplantation, which included 175 AML patients, cytomegaly serostatus and a severe donor-host reaction were relevant for survival, whereas the type of transplantation was not (1). Comparing the results of HLA compatible unrelated donor and family donor transplantations in 368 AML patients in a study showed that the donor type was not a significant prognostic factor for survival after allogenic stem cell transplantation in older patients with standard and high risk AML (2). Patients with AML who would benefit from allogeneic stem cell transplantation but who have no family donor should therefore receive a transplant from an unrelated donor. Further evaluation of both transplantation methods is, however, desirable.
DOI: 10.3238/arztebl.2008.0098b


Prof. Dr. med. Dr. h. c. Axel R. Zander,
Priv.-Doz. Dr. med. Ulrike Bacher
Interdisziplinäre Klinik und Poliklinik für Stammzelltransplantation
Universitätsklinikum Hamburg-Eppendorf; Martinistr. 52, 20246 Hamburg, Germany

Prof. Dr. med. Jürgen Finke
Abteilung für Hämatologie und Onkologie; Medizinische Universitätsklinik
Hugstetter Str. 55, 79106 Freiburg, Germany

Conflict of interest statement
The authors of both the letter and the reply declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.