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  3. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia

Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantation in adults with acute leukemia

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Ruggeri A
  • Labopin M
  • Piemontese S
  • Arcese W
  • Bacigalupo A
  • Blaise D
  • Bosi A
  • Huang H
  • Karakasis D
  • Koc Y
  • Michallet M
  • Picardi A
  • Santarone S
  • Sengelov H
  • Sierra J
  • Vincent L
  • Volt F
  • Nagler A
  • Gluckman E
  • Ciceri F
  • Rocha V
  • Mohty M
  • Eurocord, Cord Blood Committee of Cellular Therapy and Immunobiology working par
  • ALWP-EBMT study

Grupos

Abstract

Outcomes after unmanipulated haploidentical stem cell transplantation (Haplo) and after unrelated cord blood transplantation (UCBT) are encouraging and have become alternative options to treat patients with high-risk acute leukemia without human leukocyte antigen (HLA) matched donor. We compared outcomes after UCBT and Haplo in adults with de novo acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Median follow-up was 24 months. Analysis was performed separately for patients with AML, n = 918 (Haplo = 360, UCBT = 558) and ALL, n = 528 (Haplo = 158 and UCBT = 370). UCBT was associated with delayed engraftment and higher graft failure in both AML and ALL recipients. In multivariate analysis, UCBT was associated with lower incidence of chronic graft-vs-host disease both in the AML group (hazard ratio (HR) = 0.63, P = 0.008) and in the ALL group (HR = 0.58, P = 0.01). Not statistically significant differences were observed between Haplo and UCBT for relapse incidence (HR = 0.95, P = 0.76 for AML and HR = 0.82, P = 0.31 for ALL), non-relapse mortality (HR = 1.16, P = 0.47 for AML and HR = 1.23, P = 0.23 for ALL) and leukemia-free survival (HR 0.78, P = 0.78 for AML and HR = 1.00, P = 0.84 for ALL). There were no statistically differences on main outcomes after unmanipulated Haplo and UCBT, and both approaches are valid for acute leukemia patients lacking a HLA matched donor. Both strategies expand the donor pool for patients in need.

Datos de la publicación

ISSN/ISSNe:
0887-6924, 1476-5551

Leukemia  NATURE PUBLISHING GROUP

Tipo:
Article
Páginas:
1891-1900
PubMed:
25882700
Factor de Impacto:
5,189 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 174

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Keywords

  • BONE-MARROW-TRANSPLANTATION; ACUTE LYMPHOBLASTIC-LEUKEMIA; ACUTE MYELOID-LEUKEMIA; VERSUS-HOST-DISEASE; RISK ACUTE-LEUKEMIA; HEMATOLOGIC MALIGNANCIES; REDUCED-INTENSITY; POSTTRANSPLANTATION CYCLOPHOSPHAMIDE; DONOR TRANSPLANTATION; ENHANCE ENGRAFTMENT

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