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Disease-specific analyses of unrelated cord blood transplantation compared with unrelated bone marrow transplantation in adult patients with acute leukemia.

Abstract：

:We made a disease-specific comparison of unrelated cord blood (CB) recipients and human leukocyte antigen allele-matched unrelated bone marrow (BM) recipients among 484 patients with acute myeloid leukemia (AML; 173 CB and 311 BM) and 336 patients with acute lymphoblastic leukemia (ALL; 114 CB and 222 BM) who received myeloablative transplantations. In multivariate analyses, among AML cases, lower overall survival (hazard ratio [HR]=1.5; 95% confidence interval [CI], 1.0-2.0, P= .028) and leukemia-free survival (HR=1.5; 95% CI, 1.1-2.0, P= .012) were observed in CB recipients. The relapse rate did not differ between the 2 groups of AML (HR=1.2; 95% CI, 0.8-1.9, P= .38); however, the treatment-related mortality rate showed higher trend in CB recipients (HR=1.5; 95% CI, 1.0-2.3, P= .085). In ALL, there was no significant difference between the groups for relapse (HR=1.4, 95% CI, 0.8-2.4, P= .19) and treatment-related mortality (HR=1.0; 95% CI, 0.6-1.7, P= .98), which contributed to similar overall survival (HR=1.1; 95% CI, 0.7-1.6, P= .78) and leukemia-free survival (HR=1.2; 95% CI, 0.9-1.8, P= .28). Matched or mismatched single-unit CB is a favorable alternative stem cell source for patients without a human leukocyte antigen-matched related or unrelated donor. For patients with AML, decreasing mortality, especially in the early phase of transplantation, is required to improve the outcome for CB recipients.

journal_name

Blood

journal_title

Blood

authors

Atsuta Y,Suzuki R,Nagamura-Inoue T,Taniguchi S,Takahashi S,Kai S,Sakamaki H,Kouzai Y,Kasai M,Fukuda T,Azuma H,Takanashi M,Okamoto S,Tsuchida M,Kawa K,Morishima Y,Kodera Y,Kato S,Japan Cord Blood Bank Network.

doi

10.1182/blood-2008-03-147041

subject

Has Abstract

pub_date

2009-02-19 00:00:00

pages

1631-8

issue

8

eissn

0006-4971

issn

1528-0020

pii

blood-2008-03-147041

journal_volume

113

pub_type

临床试验,杂志文章

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