Comparison of Unrelated Cord Blood Transplantation and HLA-Mismatched Unrelated Bone Marrow Transplantation for Adults with Leukemia

Yoshiko Atsuta, Yasuo Morishima, Ritsuro Suzuki, Tokiko Nagamura-Inoue, Shuichi Taniguchi, Satoshi Takahashi, Shunro Kai, Hisashi Sakamaki, Yasushi Kouzai, Naoki Kobayashi, Takahiro Fukuda, Hiroshi Azuma, Minoko Takanashi, Takehiko Mori, Masahiro Tsuchida, Takakazu Kawase, Keisei Kawa, Yoshihisa Kodera, Shunichi Kato

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48 Citations (Scopus)

Abstract

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-DRB1-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-DRB1-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-DRB1-mismatched or other 7 of 8 UBMT.

Original languageEnglish
Pages (from-to)780-787
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume18
Issue number5
DOIs
Publication statusPublished - 2012 May

Keywords

  • HLA-mismatched unrelated bone marrow transplantation
  • Unrelated cord blood transplantation

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Atsuta, Y., Morishima, Y., Suzuki, R., Nagamura-Inoue, T., Taniguchi, S., Takahashi, S., Kai, S., Sakamaki, H., Kouzai, Y., Kobayashi, N., Fukuda, T., Azuma, H., Takanashi, M., Mori, T., Tsuchida, M., Kawase, T., Kawa, K., Kodera, Y., & Kato, S. (2012). Comparison of Unrelated Cord Blood Transplantation and HLA-Mismatched Unrelated Bone Marrow Transplantation for Adults with Leukemia. Biology of Blood and Marrow Transplantation, 18(5), 780-787. https://doi.org/10.1016/j.bbmt.2011.10.008