Synapse - Reduced late mortality risk contributes to similar survival after double-unit cord blood transplantation compared with related and unrelated donor hematopoietic stem cell transplantation

Reduced late mortality risk contributes to similar survival after double-unit cord blood transplantation compared with related and unrelated donor hematopoietic stem cell transplantation Journal Article

Authors:	Ponce, D. M.; Zheng, J. T.; Gonzales, A. M.; Lubin, M.; Heller, G.; Castro-Malaspina, H.; Giralt, S.; Hsu, K.; Jakubowski, A. A.; Jenq, R. R.; Koehne, G.; Papadopoulos, E. B.; Perales, M. A.; Van Den Brink, M. R.; Young, J. W.; Boulad, F.; Kernan, N. A.; Kobos, R.; Prockop, S.; Scaradavou, A.; Small, T.; O'Reilly, R. J.; Barker, J. N.
Article Title:	Reduced late mortality risk contributes to similar survival after double-unit cord blood transplantation compared with related and unrelated donor hematopoietic stem cell transplantation
Abstract:	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
Keywords:	engraftment; hematologic malignancies; remission; outcomes; adults; versus-host-disease; bone-marrow; graft; recipients; acute-leukemia; cord blood transplantation
Journal Title:	Biology of Blood and Marrow Transplantation
Volume:	17
Issue:	9
ISSN:	1083-8791
Publisher:	Elsevier Inc.
Date Published:	2011-09-01
Start Page:	1316
End Page:	1326
Language:	English
DOI:	10.1016/j.bbmt.2011.01.006
ACCESSION:	WOS:000294594900007
PROVIDER:	wos
PMCID:	PMC3156939
PUBMED:	21232625
Notes:	--- - Article - "Source: Wos"