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

dc.contributor.authorRodrigues, Celso Arrais [UNIFESP]
dc.contributor.authorRocha, Vanderson
dc.contributor.authorDreger, Peter
dc.contributor.authorBrunstein, Claudio
dc.contributor.authorSengeloev, Henrik
dc.contributor.authorFinke, Juergen
dc.contributor.authorMohty, Mohamad
dc.contributor.authorRio, Bernard
dc.contributor.authorPetersen, Eefke
dc.contributor.authorGuilhot, Francois
dc.contributor.authorNiederwieser, Dietger
dc.contributor.authorCornelissen, Jan J.
dc.contributor.authorJindra, Pavel
dc.contributor.authorNagler, Arnon
dc.contributor.authorFegueux, Nathalie
dc.contributor.authorSchoemans, Helene
dc.contributor.authorRobinson, Stephen
dc.contributor.authorRuggeri, Annalisa
dc.contributor.authorGluckman, Eliane
dc.contributor.authorCanals, Carmen
dc.contributor.authorSureda, Anna
dc.contributor.authorEuropean Grp Blood Marrow
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionHosp Sirio Libanes
dc.contributor.institutionOxford Univ Hosp
dc.contributor.institutionHop St Louis
dc.contributor.institutionUniv Heidelberg Hosp
dc.contributor.institutionUniv Minnesota
dc.contributor.institutionUniv Med Ctr Freiburg
dc.contributor.institutionHop St Antoine
dc.contributor.institutionCHU Nantes
dc.contributor.institutionUniv Paris 06
dc.contributor.institutionUniv Med Ctr
dc.contributor.institutionUniv Hosp Poitiers
dc.contributor.institutionUniv Hosp Leipzig
dc.contributor.institutionErasmus MC Daniel den Hoed
dc.contributor.institutionCharles Univ Hosp
dc.contributor.institutionChaim Sheba Med Ctr
dc.contributor.institutionCHU Lapeyronie
dc.contributor.institutionKatholieke Univ Leuven Hosp
dc.contributor.institutionAvon Haematol Unit
dc.contributor.institutionHosp Santa Creu & Sant Pau
dc.contributor.institutionCambridge Univ Hosp
dc.description.abstractWe 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.en
dc.description.affiliationUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliationHosp Sirio Libanes, Ctr Oncol, São Paulo, Brazil
dc.description.affiliationOxford Univ Hosp, Churchill Hosp, Oxford, England
dc.description.affiliationHop St Louis, Eurocord, Paris, France
dc.description.affiliationUniv Heidelberg Hosp, Heidelberg, Germany
dc.description.affiliationUniv Minnesota, Minneapolis, MN USA
dc.description.affiliationRigshosp, DK-2100 Copenhagen, Denmark
dc.description.affiliationUniv Med Ctr Freiburg, Freiburg, Germany
dc.description.affiliationHop St Antoine, Dept Hematol, F-75571 Paris, France
dc.description.affiliationCHU Nantes, Nantes, France
dc.description.affiliationUniv Paris 06, Paris, France
dc.description.affiliationINSERM, UMRs 938, Paris, France
dc.description.affiliationUniv Med Ctr, Utrecht, Netherlands
dc.description.affiliationUniv Hosp Poitiers, CIC INSERM 0802, Poitiers, France
dc.description.affiliationUniv Hosp Leipzig, Leipzig, Germany
dc.description.affiliationErasmus MC Daniel den Hoed, Rotterdam, Netherlands
dc.description.affiliationCharles Univ Hosp, Plzen, Czech Republic
dc.description.affiliationChaim Sheba Med Ctr, IL-52621 Tel Hashomer, Israel
dc.description.affiliationCHU Lapeyronie, Montpellier, France
dc.description.affiliationKatholieke Univ Leuven Hosp, Louvain, Belgium
dc.description.affiliationAvon Haematol Unit, Bristol, Avon, England
dc.description.affiliationHosp Santa Creu & Sant Pau, Barcelona, Spain
dc.description.affiliationCambridge Univ Hosp, Addenbrookes Hosp, Cambridge, England
dc.description.affiliationUnifespUniversidade Federal de São Paulo, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNational Institute for Health Research (NIHR)
dc.description.sponsorshipOxford Biomedical Research Centre at Oxford University Hospitals NHS Trust
dc.description.sponsorshipUniversity of Oxford
dc.identifier.citationHaematologica. Pavia: Ferrata Storti Foundation, v. 99, n. 2, p. 370-377, 2014.
dc.publisherFerrata Storti Foundation
dc.rightsAcesso aberto
dc.titleAlternative donor hematopoietic stem cell transplantation for mature lymphoid malignancies after reduced-intensity conditioning regimen: similar outcomes with umbilical cord blood and unrelated donor peripheral blooden
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