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

Yoshiko Atsuta, Ritsuro Suzuki, Tokiko Nagamura-Inoue, Shuichi Taniguchi, Satoshi Takahashi, Shunro Kai, Hisashi Sakamaki, Yasushi Kouzai, Masaharu Kasai, Takahiro Fukuda, Hiroshi Azuma, Minoko Takanashi, Shinichiro Okamoto, Masahiro Tsuchida, Keisei Kawa, Yasuo Morishima, Yoshihisa Kodera, Shunichi Kato

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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.

Original languageEnglish
Pages (from-to)1631-1638
Number of pages8
JournalBlood
Volume113
Issue number8
DOIs
Publication statusPublished - 2009 Feb 19

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Bone Marrow Transplantation
Fetal Blood
Hazards
Bone
Leukemia
Blood
Transplantation
Confidence Intervals
Survival
Bone Marrow
HLA Antigens
Mortality
Recurrence
Unrelated Donors
Stem cells
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia
Stem Cells
Multivariate Analysis
Alleles

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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Disease-specific analyses of unrelated cord blood transplantation compared with unrelated bone marrow transplantation in adult patients with acute leukemia. / Atsuta, Yoshiko; Suzuki, Ritsuro; Nagamura-Inoue, Tokiko; Taniguchi, Shuichi; Takahashi, Satoshi; Kai, Shunro; Sakamaki, Hisashi; Kouzai, Yasushi; Kasai, Masaharu; Fukuda, Takahiro; Azuma, Hiroshi; Takanashi, Minoko; Okamoto, Shinichiro; Tsuchida, Masahiro; Kawa, Keisei; Morishima, Yasuo; Kodera, Yoshihisa; Kato, Shunichi.

In: Blood, Vol. 113, No. 8, 19.02.2009, p. 1631-1638.

Research output: Contribution to journalArticle

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 2009, 'Disease-specific analyses of unrelated cord blood transplantation compared with unrelated bone marrow transplantation in adult patients with acute leukemia', Blood, vol. 113, no. 8, pp. 1631-1638. https://doi.org/10.1182/blood-2008-03-147041
Atsuta, Yoshiko ; Suzuki, Ritsuro ; Nagamura-Inoue, Tokiko ; Taniguchi, Shuichi ; Takahashi, Satoshi ; Kai, Shunro ; Sakamaki, Hisashi ; Kouzai, Yasushi ; Kasai, Masaharu ; Fukuda, Takahiro ; Azuma, Hiroshi ; Takanashi, Minoko ; Okamoto, Shinichiro ; Tsuchida, Masahiro ; Kawa, Keisei ; Morishima, Yasuo ; Kodera, Yoshihisa ; Kato, Shunichi. / Disease-specific analyses of unrelated cord blood transplantation compared with unrelated bone marrow transplantation in adult patients with acute leukemia. In: Blood. 2009 ; Vol. 113, No. 8. pp. 1631-1638.
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AU - Takahashi, Satoshi

AU - Kai, Shunro

AU - Sakamaki, Hisashi

AU - Kouzai, Yasushi

AU - Kasai, Masaharu

AU - Fukuda, Takahiro

AU - Azuma, Hiroshi

AU - Takanashi, Minoko

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AU - Tsuchida, Masahiro

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