Unrelated cord blood and mismatched unrelated volunteer donor transplants, two alternatives in patients who lack an HLA-identical donor
- 1 September 2008
- journal article
- research article
- Published by Springer Science and Business Media LLC in Bone Marrow Transplantation
- Vol. 42 (10), 643-648
- https://doi.org/10.1038/bmt.2008.239
Abstract
The aim was to evaluate two transplant strategies for patients who lack HLA-identical donors, namely HLA-A, HLA-B or -DRβ1 mismatched unrelated donor (MM URD) transplants (n=14) and umbilical cord blood transplants (UCB, n=27). Diagnosis, disease stage and age were similar in the two groups. Cell dose was lower in the UCB group (P0.5 × 109/l was 30 days in the UCB group and 17 days in the MM URD group (P=0.002). Engraftment of plt was delayed in the UCB group (P=0.03). The UCB patients required fewer erythrocyte transfusions (P=0.001). At 100 days, complete donor chimerism for CD3 was 63 and 44% in the UCB and MM URD groups, respectively. Acute GVHD of grades II–IV were 30% in the UCB group and 21% in the MM URD group. The corresponding figures for chronic GVHD were 9 and 20%, respectively. TRM was 30% in the UCB patients and 50% in the MM URD patients. Three-year survival was 66% in the UCB group and 14% in the MM URD group (P=0.006). Although the material is small and heterogeneous, engraftment was delayed, leukocyte chimerism was not significantly different and survival was superior using UCB rather than MM URD transplants.Keywords
This publication has 32 references indexed in Scilit:
- Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic diseaseBlood, 2007
- Reduced intensity allogeneic umbilical cord blood transplantation in children and adolescent recipients with malignant and non-malignant diseasesBone Marrow Transplantation, 2007
- Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison studyThe Lancet, 2007
- Adult recipients of umbilical cord blood transplants after nonmyeloablative preparative regimensTransplantation and Cellular Therapy, 2004
- Dose Study of Thymoglobulin During Conditioning for Unrelated Donor Allogeneic Stem-Cell TransplantationTransplantation, 2004
- Rapid and complete donor chimerism in adult recipients of unrelated donor umbilical cord blood transplantation after reduced-intensity conditioningBlood, 2003
- Home care during the pancytopenic phase after allogeneic hematopoietic stem cell transplantation is advantageous compared with hospital careBlood, 2002
- Comparison of outcomes of unrelated bone marrow and umbilical cord blood transplants in children with acute leukemiaBlood, 2001
- TRANSPLANTATION OF AUTOLOGOUS AND ALLOGENEIC BONE MARROW WITH LIVER FROM A CADAVERIC DONOR FOR PRIMARY LIVER CANCER1Transplantation, 2000
- MARROW TRANSPLANTATION FROM HLA-MATCHED UNRELATED DONORS FOR TREATMENT OF HEMATOLOGIC MALIGNANCIESTransplantation, 1991