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- Comparison of Unrelated Cord Blood and Peripheral Blood Stem Cell Transplantation in Adults with Myelodysplastic Syndrome after Reduced-Intensity Conditioning Regimen: A Collaborative Study from Eurocord (Cord blood Committee of Cellular Therapy & Immunobiology Working Party of EBMT) and Chronic Malignancies Working Party
Comparison of Unrelated Cord Blood and Peripheral Blood Stem Cell Transplantation in Adults with Myelodysplastic Syndrome after Reduced-Intensity Conditioning Regimen: A Collaborative Study from Eurocord (Cord blood Committee of Cellular Therapy & Immunobiology Working Party of EBMT) and Chronic Malignancies Working Party
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Robin M
- Ruggeri A
- Labopin M
- Niederwieser D
- Tabrizi R
- Bourhis JH
- van Biezen A
- Koenecke C
- Blaise D
- Tischer J
- Craddock C
- Maillard N
- Mohty M
- Russel N
- Schetelig J
- Finke J
- Gluckman E
- de Witte TM
- Rocha V
- Kroger N
Grupos
Abstract
Hematopoietic stem cell transplantation (HSCT) remains the only curative treatment in patients with higher risk myelodysplastic syndrome (MDS), but the choice of the optimal alternative stem cell source is still a subject of debate in patients lacking an HLA-matched sibling donor. Here, we report on a large series of patients with MDS (N = 631) transplanted either with mobilized peripheral stem cells (PBS) from unrelated donors (n = 502) or with umbilical cord blood transplant (UCB, n = 129) as alternative grafts after reduced-intensity conditioning. Neutrophil engraftment was higher after PB (98% versus 78%, P < .0001). Acute graft-versus-host disease (GVHD) was similar after PB (31%) and UCB (29%), and chronic GVHD incidence was higher after PB (41% versus 23%). Two-year nonrelapse mortality was lower after PB (31% versus 42% P = .03). There was a better overall survival (OS) and disease-free survival (DFS) after PB (49% +/- 2% versus 30% +/- 4%, P < .0001 and 44% +/- 2% versus 28% +/- 4%, P < .0001). Multivariate analysis confirmed the advantage of PB for treatment-related mortality, OS, and DFS, whereas relative risk of chronic GVHD was similar. A multivariate analysis comparing PB from a 10/10 HLA-matched donor, PB from a 9/10 HLA-matched donor, and UCB showed an advantage on treatment-related mortality, DFS, and OS only in 10/10 PB. We conclude that in MDS patients lacking an HLA-matched sibling donor, PB from a 10/10 HLA-matched unrelated donor is the preferred source of hematopoietic stem cells. HLA-mismatched unrelated donor or cord blood seem to give similar inferior results except for neutrophil engraftment, which is delayed after UCB. (C) 2015 American Society for Blood and Marrow Transplantation.
Datos de la publicación
- ISSN/ISSNe:
- 1083-8791, 1523-6536
- Tipo:
- Article
- Páginas:
- 489-495
- Factor de Impacto:
- 2,060 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION ELSEVIER SCIENCE INC
Citas Recibidas en Web of Science: 41
Documentos
- No hay documentos
Filiaciones
Keywords
- Myelodysplastic syndrome; Cord blood transplant; Reduced-intensity conditioning regimen; Alternative donors
Proyectos asociados
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TPH
Cita
Robin M,Ruggeri A,Labopin M,Niederwieser D,Tabrizi R,Sanz G,Bourhis JH,van A,Koenecke C,Blaise D,Tischer J,Craddock C,Maillard N,Mohty M,Russel N,Schetelig J,Finke J,Gluckman E,de Witte TM,Rocha V,Kroger N. Comparison of Unrelated Cord Blood and Peripheral Blood Stem Cell Transplantation in Adults with Myelodysplastic Syndrome after Reduced-Intensity Conditioning Regimen: A Collaborative Study from Eurocord (Cord blood Committee of Cellular Therapy & Immunobiology Working Party of EBMT) and Chronic Malignancies Working Party. Biol Blood Marrow Transplant. 2015. 21. (3):p. 489-495. IF:3,980. (1).