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

研究成果: Article査読

52 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)780-787
ページ数8
ジャーナルBiology of Blood and Marrow Transplantation
18
5
DOI
出版ステータスPublished - 2012 5
外部発表はい

ASJC Scopus subject areas

  • 血液学
  • 移植

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