Evidence map›Paper›PMID 31449184›Full record

ArticleTransplantation2020

Long-term Outcome of Allogeneic Hematopoietic Stem Cell Transplantation From Unrelated Donor Using Tacrolimus/Sirolimus-based GvHD Prophylaxis: Impact of HLA Mismatch.

Monzr M Al Malki, Ketevan Gendzekhadze, Dongyun Yang, Sally Mokhtari, Pablo Parker, Chatchada Karanes, Joycelynne Palmer, David Snyder, Stephen J Forman, Auayporn Nademanee and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Transplantation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% 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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  4. Review
  5. Article
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  7. Article
  8. Article
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  11. New strategies for mismatched unrelated donor (MMUD) hematopoietic cell transplant (HCT).Hematology. American Society of Hematology. Education Program · 2022
    Article
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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

11 authors at 1 institution in 1 country.

Monzr M Al MalkiDepartment of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA.
Ketevan GendzekhadzeHLA laboratory, City of Hope, Duarte, CA.
Dongyun YangDepartment of Information Sciences, Division of Biostatistics, City of Hope, Duarte, CA.
Sally MokhtariDepartment of Clinical Translational Program Development, City of Hope, Duarte, CA.
Pablo ParkerDepartment of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA.
Chatchada KaranesDepartment of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA.
Joycelynne PalmerDepartment of Information Sciences, Division of Biostatistics, City of Hope, Duarte, CA.
David SnyderDepartment of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA.
Stephen J FormanDepartment of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA.
Auayporn NademaneeDepartment of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA.
Ryotaro NakamuraDepartment of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA.
City of Hope · US

Funding

Transgenic Mouse FacilityP30CA033572 · NCI · CITY OF HOPE/BECKMAN RESEARCH INSTITUTE · PI XIWEI WU · 1985 to 2026
$86.3M
NCI NIH HHS P30 CA033572
6 · The paper itself

Abstract

backgroundWhile tacrolimus and sirolimus (T/S)-based graft-versus-host disease (GvHD) prophylaxis has been effective in preventing acute GvHD post hematopoietic cell transplantation (HCT), its efficacy and long-term outcome in matched (MUD) and mismatched unrelated donor (mMUD) setting is not well defined.

methodsHerein, we evaluated a consecutive case-series of 482 patients who underwent unrelated donor HCT (2005-2013) with T/S-based GvHD prophylaxis.

resultsWith a median follow-up of 6.2 years (range = 2.4-11.3), the 5-year overall survival (OS) and relapse/progression-free survival were 47.5% (95% confidence interval [CI]: 43.0-52.0) and 43.6% (95% CI: 39.1-48.1), respectively; and the 5-year cumulative incidence of nonrelapse mortality (NRM) and relapse were 24.9%, and 31.5%, respectively. In this cohort, mMUD was associated with worse OS (39.0% versus 50.7% at 5 y; P = 0.034), primarily due to greater risk of NRM (33.5% versus 21.7%; P = 0.038). While rates of relapse, acute (II-IV or III-IV) or chronic GvHD (limited or extensive) were not different, death caused by chronic GvHD (20.8% versus 12.8%; P = 0.022) and infection (33.0% versus 18.1%; P < 0.01) were significantly greater in mMUD. In multivariable analysis, high-risk disease (hazard ratio [HR] = 2.21, 95% CI: 1.16-4.23; P < 0.01) and mMUD (HR = 1.55, 95% CI: 1.15-2.08; P = 0.004) were independent predictive factors for OS.

conclusionsT/S-based GvHD prophylaxis is an effective and acceptable GvHD prophylactic regimen. However, survival after mMUD remained poor, possibly related to the severity of chronic GvHD.

Indexed as

ForecastingUnrelated DonorsChronic DiseaseDisease-Free SurvivalFemaleFollow-Up StudiesGraft vs Host DiseaseHematologic NeoplasmsHematopoietic Stem Cell TransplantationHistocompatibility TestingHLA AntigensHumansImmunosuppressive AgentsIncidenceMaleMiddle AgedHLA AntigensImmunosuppressive AgentsSirolimusTacrolimus

Identifiers

PMID31449184
PMCPMC9071270
OpenAlexW2969487339

What OpenQuestion holds

Textmetadata
LicenceTDM
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.