TY - JOUR
T1 - Comparison of Unrelated Cord Blood Transplantation and HLA-Mismatched Unrelated Bone Marrow Transplantation for Adults with Leukemia
AU - Atsuta, Yoshiko
AU - Morishima, Yasuo
AU - Suzuki, Ritsuro
AU - Nagamura-Inoue, Tokiko
AU - Taniguchi, Shuichi
AU - Takahashi, Satoshi
AU - Kai, Shunro
AU - Sakamaki, Hisashi
AU - Kouzai, Yasushi
AU - Kobayashi, Naoki
AU - Fukuda, Takahiro
AU - Azuma, Hiroshi
AU - Takanashi, Minoko
AU - Mori, Takehiko
AU - Tsuchida, Masahiro
AU - Kawase, Takakazu
AU - Kawa, Keisei
AU - Kodera, Yoshihisa
AU - Kato, Shunichi
N1 - Funding Information:
The authors are grateful for the assistance and cooperation of all the staff members of the collaborating institutes of the Japan Cord Blood Bank Network and Japan Marrow Donor Program. This work was supported by a Research Grant for Tissue Engineering (H17-014), a Research Grant for Allergic Disease and Immunology (H20-015), a Research Grant for Cancer (H19-1), and a Research Grant for Allergic Disease and Immunology (H23-010) from the Japanese Ministry of Health, Labor, and Welfare.
PY - 2012/5
Y1 - 2012/5
N2 - Recent advances in unrelated cord blood transplantation (UCBT) and high-resolution typing of human leukocyte antigen (HLA) from an unrelated donor have increased choices in alternative donor/stem cell source selection. We assessed HLA-mismatched locus-specific comparison of the outcomes of 351 single-unit UCB and 1,028 unrelated bone marrow (UBM) adult recipients 16 years old or older at the time of transplantation who received first stem cell transplantation with myeloablative conditioning for acute leukemia or myelodysplastic syndromes. With adjusted analyses, HLA 0 to 2 mismatched UCBT showed similar overall mortality (relative risk [RR] = 0.85, 95% confidence interval [CI], 0.68-1.06; P = .149) compared with that of single-HLA-DRB1-mismatched UBMT. UCBT showed inferior neutrophil recovery (RR = 0.50, 95% CI, 0.42-0.60; P < .001), lower risk of acute graft-versus-host disease (RR = 0.55, 95% CI, 0.42-0.72; P < .001), and lower risk of transplantation-related mortality (RR = 0.68, 95% CI, 0.50-0.92; P = .011) compared with single-HLA-DRB1-mismatched UBMT. No significant difference was observed for risk of relapse (RR = 1.28, 95% CI, 0.93-1.76; P = .125). HLA 0 to 2 antigen-mismatched UCBT is a reasonable second alternative donor/stem cell source with a survival outcome similar to that of single-HLA-DRB1-mismatched or other 7 of 8 UBMT.
AB - Recent advances in unrelated cord blood transplantation (UCBT) and high-resolution typing of human leukocyte antigen (HLA) from an unrelated donor have increased choices in alternative donor/stem cell source selection. We assessed HLA-mismatched locus-specific comparison of the outcomes of 351 single-unit UCB and 1,028 unrelated bone marrow (UBM) adult recipients 16 years old or older at the time of transplantation who received first stem cell transplantation with myeloablative conditioning for acute leukemia or myelodysplastic syndromes. With adjusted analyses, HLA 0 to 2 mismatched UCBT showed similar overall mortality (relative risk [RR] = 0.85, 95% confidence interval [CI], 0.68-1.06; P = .149) compared with that of single-HLA-DRB1-mismatched UBMT. UCBT showed inferior neutrophil recovery (RR = 0.50, 95% CI, 0.42-0.60; P < .001), lower risk of acute graft-versus-host disease (RR = 0.55, 95% CI, 0.42-0.72; P < .001), and lower risk of transplantation-related mortality (RR = 0.68, 95% CI, 0.50-0.92; P = .011) compared with single-HLA-DRB1-mismatched UBMT. No significant difference was observed for risk of relapse (RR = 1.28, 95% CI, 0.93-1.76; P = .125). HLA 0 to 2 antigen-mismatched UCBT is a reasonable second alternative donor/stem cell source with a survival outcome similar to that of single-HLA-DRB1-mismatched or other 7 of 8 UBMT.
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U2 - 10.1016/j.bbmt.2011.10.008
DO - 10.1016/j.bbmt.2011.10.008
M3 - Article
C2 - 22008851
AN - SCOPUS:84859832005
SN - 1083-8791
VL - 18
SP - 780
EP - 787
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -
