Stem cell transplantation from identical twins in patients with myelodysplastic syndromes

N. Kröger, R. Brand, A. van Biezen, D. Bron, D. Blaise, E. Hellström-Lindberg, G. Gahrton, R. Powles, T. Littlewood, B. Chapuis, A. Zander, V. Koza, D. Niederwieser, T. de Witte, A. Gratwohl, R. Barge, D. Bunjes, A. Devergie, J. L. Harousseau, B. SimonssonJ. Reiffers, E. P. Alessandrino, B. Hertenstein, H. J. Kolb, M. Attal, A. Vitek, M. A. Sanz, J. Holowiecki, J. M. Moraleda, A. C. Newland, J. Finke

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13 Scopus citations


In a multicentre retrospective EBMT database study, we analysed factors influencing outcome in 38 patients with MDS/sAML who were transplanted with stem cells from their syngeneic twin and compared those to 1444 patients who were transplanted from an HLA-dentical sibling. The median time to leukocyte and platelet engraftment was faster in the twin group: 14 vs 17 (P = 0.02) and 16 vs 26 days (P = 0.09), respectively. The 5 years cumulative incidence of treatment-related mortality (TRM) was higher in the sibling than in the twin group (38 vs 27%; P = 0.05). The 5 year cumulative incidence of relapse was 32% (95% CI: 29-35%) for the siblings and 39% (95% CI: 26-60%; P = 0.6) for the twins. A trend for better 5-years disease-free and overall survival was observed in the twin group: 34% (95% CI: 14-54%) Ps 28% (95% CI: 25-31 %; P = 0.2) and 36% (95% CI: 15-57%) vs 32% (95% CI: 29-35%; P=0.09), respectively. In a multivariate analysis, stem cell transplantation from identical twins had a lower TRM: HR: 0.4 (95% CI: 0.2-0.9; P=0.03). The relapse rate was similar for both groups with a HR of 1.2 (95% CI: 0.07-2.1; P=0.5), with a better survival for the twins: HR 0.6 (95% CI: 0.4-1.0; P=0.07). We conclude that twin transplantation in MDS/sAML is associated with a similar relapse risk, a lower TRM and a trend for better overall survival in comparison to transplantation from HLA-identical siblings.

Original languageEnglish
Pages (from-to)37-43
Number of pages7
JournalBone Marrow Transplantation
Issue number1
StatePublished - 2005
Externally publishedYes


  • Allogeneic stem cell transplantation
  • Myelodysplastic syndrome
  • Syngeneic stem cell transplantation


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