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Comparative effectiveness review of the influence of stem cell source on allogeneic stem cell transplant effectiveness for treatment of chronic myelogenous leukemia |
HAYES, Inc. |
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Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Comparative effectiveness review of the influence of stem cell source on allogeneic stem cell transplant effectiveness for treatment of chronic myelogenous leukemia. Lansdale: HAYES, Inc.. Directory Publication. 2016 Authors' conclusions Patients with chronic myelogenous leukemia (CML) overproduce partially mature, abnormal white blood cells of the myeloid lineage. Allogeneic hematopoietic stem cell transplantation (HSCT) is a procedure in which patients undergo high-dose chemotherapy and/or radiotherapy to destroy their abnormal bone marrow and leukemia cells. This is followed by transplantation of stem cells harvested from a healthy donor to reestablish normal hematopoiesis and exert a graft-versusleukemia effect. Donor stem cells for transplant are harvested from bone marrow, peripheral blood, or umbilical cord blood. The optimal donor choice is a matched sibling donor; alternatives are matched related or unrelated donors. HSCT outcomes are influenced by multiple factors, including donor factors, and stem cell source. Controversy: The risk of transplant-related morbidity and
mortality are a major concern and a barrier for many patients. Additionally, the optimal timing of transplant is under debate, particularly for patients in chronic phase (CP) CML. The relative access to a fully matched related donor (RD) or matched unrelated donor (MURD) may strongly influence the outcomes of the transplant. Questions remain regarding how differences in the composition of graft sources, i.e., peripheral blood stem cell transplantation (PBSCT) or bone marrow transplantation (BMT), influence outcomes.
Relevant Questions: How do remission, survival, and relapse rates following allogeneic HSCT for CML compare between the use of BMT and PBSCT? How do remission, survival, and relapse compare between HSCT performed with stem cells harvested from an human leukocyte antigen (HLA)-matched sibling donor and those using grafts from related and unrelated donors, or from mismatched donors? How do safety outcomes compare between allogeneic HSCT using different graft and donor sources? Have definitive patient selection criteria been established for the use of BMT versus PBSCT, and for the various donor graft sources? Indexing Status Subject indexing assigned by CRD MeSH Humans; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Stem Cell Transplantation Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc., 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218 Email: hayesinfo@hayesinc.com AccessionNumber 32016000978 Date abstract record published 31/08/2016 |
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