6533b831fe1ef96bd129990d

RESEARCH PRODUCT

Single umbilical cord blood with or without CD34+ cells from a third-party donor in adults with leukemia

Miguel A. SanzMiguel A. SanzChristelle FerraPere BarbaPascual BalsalobrePascual BalsalobreMaría Jesús PascualMi KwonMi KwonIgnacio LorenzoCarlos SolanoJosé Luis Díez-martínJosé Luis Díez-martínCarmen RegidorJosé Luis PiñanaRafael CabreraRafael F. DuarteIsmael BuñoIsmael BuñoJorge GayosoJorge GayosoCarmen MartínGuillermo SanzGuillermo SanzAlmudena De La IglesiaGuiomar BautistaJuan MontoroJaime SanzJaime SanzRodrigo Martino

subject

Acute leukemiamedicine.medical_specialtyendocrine systemTransplantationbusiness.industryHazard ratioMyeloid leukemiaContext (language use)Hematologymedicine.diseaseUmbilical cordGastroenterologyTransplantation03 medical and health sciencesLeukemia0302 clinical medicinemedicine.anatomical_structureGraft-versus-host disease030220 oncology & carcinogenesisInternal medicineImmunologyMedicinebusiness030215 immunology

description

We retrospectively compared the clinical outcomes of adults with acute leukemia who received single-unit umbilical cord blood (UCB) transplantation (sUCBT) (n = 135) or stem cell transplant using coinfusion of a UCB graft with CD34+ cells from a third-party donor (Haplo-Cord) (n = 72) at different institutions within the Grupo Espanol de Trasplante Hematopoyetico. In multivariable analysis, patients in the Haplo-Cord group showed more rapid neutrophil (hazard ratio [HR], 2.3; 95% confidence interval [CI], 1.5-3.3; P < .001) and platelet recovery (HR, 1.6; 95% CI, 1.2-2.3; P = .015) and lower incidence of chronic graft-versus-host disease (GVHD) (relative risk, 0.5; 95% CI, 0.3-0.8; P = .01). Nonrelapse mortality, relapse, disease-free survival (DFS), and GVHD/relapse-free survival were similar in the 2 groups. Regarding disease-specific outcomes, DFS in both acute myeloid leukemia (AML) and acute lymphoblastic leukemia patients was not significantly different; however, a significantly higher relapse rate was found in patients with AML treated with Haplo-Cord (HR, 2.3; 95% CI, 1-5.4; P = .04). Our study confirms that Haplo-Cord was an effective strategy to accelerate neutrophil and platelet recovery and shows that, in the context of specific treatment platforms, sUCBT and Haplo-Cord offer similar long-term outcomes.

yearjournalcountryeditionlanguage
2017-06-20
10.1182/bloodadvances.2017006999https://europepmc.org/articles/PMC5728323/