Evidence map›Paper›PMID 28270691›Full record

ArticleLeukemia2017

Alloreactivity: the Janus-face of hematopoietic stem cell transplantation.

A Gratwohl, A Sureda, J Cornelissen, J Apperley, P Dreger, R Duarte, H T Greinix, E Mc Grath, N Kroeger, F Lanza and 4 more

Open access · hybridAbstract read
PubMed Publisher
In one paragraph

Article in Leukemia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 31 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Review
  8. Selection of matched unrelated donors moving forward: from HLA allele counting to functional matching.Hematology. American Society of Hematology. Education Program · 2019
    Review
  9. Article
  10. Article
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 7 countries.

A GratwohlEBMT Activity Survey Office, University Hospital, Basel, Switzerland.
A SuredaICO Institute of Clinical Oncology, ICO-Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain.
J CornelissenHematology, Erasmus University Medical Center, Rotterdam, The Netherlands.
J ApperleyHaematology, Hammersmith Hospital, London, UK.
P DregerMedical Clinic and Policlinic, University of Heidelberg, Heidelberg, Germany.
R DuarteDepartment of Hematology, University Hospital Puerta de Hierro Majadahonda, Madrid, Spain.
H T GreinixDivision of Hematology, Medical University of Graz, Graz, Austria.
E Mc GrathJACIE Accreditation Office, Barcelona, Spain.
N KroegerDepartment of Stem Cell Transplantation, University Hospital Eppendorf, Hamburg, Germany.
F LanzaUnità Operativa di Ematologia, Ospedale Civile, Ravenna, Italy.
A NaglerStem Cell Transplantation Unit, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
J A SnowdenDepartment of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, and Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
D NiederwieserHematology and Oncology, University Hospital, Leipzig, Germany.
R BrandDepartment of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands.
Heidelberg University · DELeiden University · NLMedical University of Graz · ATSheba Medical Center · ILUniversität Hamburg · DEUniversity Hospital of Basel · CHErasmus MC · NLHammersmith Hospital · GBSheffield Teaching Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Differences in major and minor histocompatibility antigens between donor and recipient trigger powerful graft-versus-host reactions after allogeneic hematopoietic stem cell transplantation (HSCT). The clinical effects of alloreactivity present a Janus-face: detrimental graft-versus-host disease increases non-relapse mortality, beneficial graft-versus-malignancy may cure the recipient. The ultimate consequences on long-term outcome remain a matter of debate. We hypothesized that increasing donor-recipient antigen matching would decrease the negative effects, while preserving antitumor alloreactivity. We analyzed retrospectively a predefined cohort of 32 838 such patients and compared it to 59 692 patients with autologous HSCT as reference group. We found a significant and systematic decrease in non-relapse mortality with decreasing phenotypic and genotypic antigen disparity, paralleled by a stepwise increase in overall and relapse-free survival (Spearman correlation coefficients of cumulative excess event rates at 5 years 0.964; P<0.00; respectively 0.976; P<0.00). We observed this systematic stepwise effect in all main disease and disease-stage categories. The results suggest that detrimental effects of alloreactivity are additive with each step of mismatching; the beneficial effects remain preserved. Hence, if there is a choice, the best match should be donor of choice. The data support an intensified search for predictive genomic and environmental factors of 'no-graft-versus-host disease'.

Indexed as

Hematopoietic Stem Cell TransplantationGraft vs Host DiseaseHistocompatibility TestingHumansRetrospective StudiesTransplantation, Homologous

Identifiers

PMID28270691
OpenAlexW2594275567

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.