Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 18, Issue 5, Pages 780-787Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2011.10.008
Keywords
Unrelated cord blood transplantation; HLA-mismatched unrelated bone marrow transplantation
Categories
Funding
- Japanese Ministry of Health, Labor, and Welfare [H17-014, H20-015, H19-1, H23-010]
- Grants-in-Aid for Scientific Research [21591239, 23791077] Funding Source: KAKEN
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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-DRBI-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-DRBI-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-DRBI-mismatched or other 7 of 8 UBMT. Biol Blood Marrow Transplant 18: 780-787 (2012) (C) 2012 American Society for Blood and Marrow Transplantation
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