{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:36:14Z","timestamp":1790786174544,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>While 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>Herein, we evaluated a consecutive case-series of 482 patients who underwent unrelated donor HCT (2005\u20132013) with T\/S-based GvHD prophylaxis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>With a median follow-up of 6.2 years (range = 2.4\u201311.3), 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; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.034), primarily due to greater risk of NRM (33.5% versus 21.7%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.038). While rates of relapse, acute (II\u2013IV or III\u2013IV) or chronic GvHD (limited or extensive) were not different, death caused by chronic GvHD (20.8% versus 12.8%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.022) and infection (33.0% versus 18.1%; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01) were significantly greater in mMUD. In multivariable analysis, high-risk disease (hazard ratio [HR] = 2.21, 95% CI: 1.16-4.23; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01) and mMUD (HR = 1.55, 95% CI: 1.15-2.08; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.004) were independent predictive factors for OS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions.<\/jats:title>\n            <jats:p>T\/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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/tp.0000000000002932","type":"journal-article","created":{"date-parts":[[2019,8,24]],"date-time":"2019-08-24T13:34:04Z","timestamp":1566653644000},"page":"1070-1080","source":"Crossref","is-referenced-by-count":21,"title":["Long-term Outcome of Allogeneic Hematopoietic Stem Cell Transplantation From Unrelated Donor Using Tacrolimus\/Sirolimus-based GvHD Prophylaxis: Impact of HLA Mismatch"],"prefix":"10.1097","volume":"104","author":[{"given":"Monzr M.","family":"Al Malki","sequence":"first","affiliation":[{"name":"Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketevan","family":"Gendzekhadze","sequence":"additional","affiliation":[{"name":"HLA laboratory, City of Hope, Duarte, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Information Sciences, Division of Biostatistics, City of Hope, Duarte, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Mokhtari","sequence":"additional","affiliation":[{"name":"Department of Clinical Translational Program Development, City of Hope, Duarte, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chatchada","family":"Karanes","sequence":"additional","affiliation":[{"name":"Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joycelynne","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Information Sciences, Division of Biostatistics, City of Hope, Duarte, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Forman","sequence":"additional","affiliation":[{"name":"Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Auayporn","family":"Nademanee","sequence":"additional","affiliation":[{"name":"Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryotaro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20231002","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1056\/NEJMsa1311707","article-title":"HLA match likelihoods for hematopoietic stem-cell grafts in the U.S. Registry.","volume":"371","author":"Gragert","year":"2014","journal-title":"N Engl J Med"},{"key":"R2-20231002","doi-asserted-by":"crossref","first-page":"4576","DOI":"10.1182\/blood-2007-06-097386","article-title":"High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow 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The 2014 Diagnosis and Staging Working Group report.","volume":"21","author":"Jagasia","year":"2015","journal-title":"Biol Blood Marrow Transplant"},{"key":"R24-20231002","doi-asserted-by":"crossref","first-page":"15358","DOI":"10.1073\/pnas.93.26.15358","article-title":"Definition of HLA-DQ as a transplantation antigen.","volume":"93","author":"Petersdorf","year":"1996","journal-title":"Proc Natl Acad Sci U S A"}],"container-title":["Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/TP.0000000000002932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T05:23:15Z","timestamp":1696224195000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/TP.0000000000002932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/tp.0000000000002932","relation":{},"ISSN":["0041-1337"],"issn-type":[{"value":"0041-1337","type":"print"}],"subject":[],"published":{"date-parts":[[2020,5]]}}}