Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 17, Issue 9, Pages 1316-1326Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2011.01.006
Keywords
Cord blood transplantation
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Funding
- New York State Empire
- Gabrielle's Angel Foundation for Cancer Research
- Memorial Sloan-Kettering Cancer Center Society
- National Cancer Institute, National Institutes of Health [P01 CA23766]
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Cord blood transplantation (CB-T) is increasingly used as a treatment alternative for hematologic malignancies. However, how CB-T compares to related (RD-T) and unrelated donor transplantation (URD-T) is not established. We compared survival of 75 double-unit CB-T, 108 RD-T, and 184 URD-T recipients who received transplants over the same period for the treatment of hematologic malignancies. Patients had similar ages and disease risk, and a similar percentage had acute leukemia. The incidence of day 180 transplant-related mortality (TRM) of 21% (95% confidence interval [CI]: 12-31) after CB-T was higher than that of RD-T recipients. However, this was compensated for by a low risk of TRM after day 180, and a relatively low incidence of relapse. Hence, the 2-year progression-free survival (PFS) of 55% (95% CI: 45-68) after CB-T was similar to that after RD-T or URD-T (P=.573). In multivariate analysis, donor source had no influence on PFS, with the only significant factors being recipient age and disease risk. In a subanalysis of 201 patients with acute leukemia, CB-T, RD-T, and URD-T recipients also had similar 2-year disease-free survival (P=.482). These data provide strong support for the further investigation of double-unit CB grafts as an alternative hematopoietic stem cell source. Biol Blood Marrow Transplant 17: 1316-1326 (2011) (C) 2011 American Society for Blood and Marrow Transplantation
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