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Title: Alternative donor hematopoietic stem cell transplantation for mature lymphoid malignancies after reduced-intensity conditioning regimen: similar outcomes with umbilical cord blood and unrelated donor peripheral blood
Authors: Rodrigues, Celso Arrais [UNIFESP]
Rocha, Vanderson
Dreger, Peter
Brunstein, Claudio
Sengeloev, Henrik
Finke, Juergen
Mohty, Mohamad
Rio, Bernard
Petersen, Eefke
Guilhot, Francois
Niederwieser, Dietger
Cornelissen, Jan J.
Jindra, Pavel
Nagler, Arnon
Fegueux, Nathalie
Schoemans, Helene
Robinson, Stephen
Ruggeri, Annalisa
Gluckman, Eliane
Canals, Carmen
Sureda, Anna
European Grp Blood Marrow
Universidade Federal de São Paulo (UNIFESP)
Hosp Sirio Libanes
Oxford Univ Hosp
Hop St Louis
Univ Heidelberg Hosp
Univ Minnesota
Univ Med Ctr Freiburg
Hop St Antoine
CHU Nantes
Univ Paris 06
Univ Med Ctr
Univ Hosp Poitiers
Univ Hosp Leipzig
Erasmus MC Daniel den Hoed
Charles Univ Hosp
Chaim Sheba Med Ctr
CHU Lapeyronie
Katholieke Univ Leuven Hosp
Avon Haematol Unit
Hosp Santa Creu & Sant Pau
Cambridge Univ Hosp
Issue Date: 1-Feb-2014
Publisher: Ferrata Storti Foundation
Citation: Haematologica. Pavia: Ferrata Storti Foundation, v. 99, n. 2, p. 370-377, 2014.
Abstract: We have reported encouraging results of unrelated cord blood transplantation for patients with lymphoid malignancies. Whether those outcomes are comparable to matched unrelated donor transplants remains to be defined. We studied 645 adult patients with mature lymphoid malignancies who received an allogeneic unrelated donor transplant using umbilical cord blood (n=104) or mobilized peripheral blood stem cells (n=541) after a reduced-intensity conditioning regimen. Unrelated cord blood recipients had more refractory disease. Median follow-up time was 30 months. Neutrophil engraftment (81% vs. 97%, respectively; P<0.0001) and chronic graft-versus-host disease (26% vs. 52%; P=0.0005) were less frequent after unrelated cord blood than after matched unrelated donor, whereas no differences were observed in grade II-IV acute graft-versus-host disease (29% vs. 32%), non-relapse mortality (29% vs. 28%), and relapse or progression (28% vs. 35%) at 36 months. There were also no significant differences in 2-year progression-free survival (43% vs. 58%, respectively) and overall survival (36% vs. 51%) at 36 months. in a multivariate analysis, no differences were observed in the outcomes between the two stem cell sources except for a higher risk of neutrophil engraftment (hazard ratio=2.12; P<0.0001) and chronic graft-versus-host disease (hazard ratio 2.10; P=0.0002) after matched unrelated donor transplant. in conclusion, there was no difference in final outcomes after transplantation between umbilical cord blood and matched unrelated donor transplant. Umbilical cord blood is a valuable alternative for patients with lymphoid malignancies lacking an HLA-matched donor, being associated with lower risk of chronic graft-versus-host disease.
ISSN: 0390-6078
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