Comparison of Unrelated Cord Blood Transplantation and HLA-Mismatched Unrelated Bone Marrow Transplantation for Adults with Leukemia

被引：59

作者：

Atsuta, Yoshiko ^{[1
]}

Morishima, Yasuo ^{[2
]}

Suzuki, Ritsuro ^{[1
]}

Nagamura-Inoue, Tokiko ^{[3
,4
]}

Taniguchi, Shuichi ^{[5
]}

Takahashi, Satoshi ^{[6
]}

Kai, Shunro ^{[7
]}

Sakamaki, Hisashi ^{[8
]}

Kouzai, Yasushi ^{[9
]}

Kobayashi, Naoki ^{[10
]}

Fukuda, Takahiro ^{[11
]}

Azuma, Hiroshi ^{[12
]}

Takanashi, Minoko ^{[13
]}

Mori, Takehiko ^{[14
]}

Tsuchida, Masahiro ^{[15
]}

Kawase, Takakazu ^{[16
]}

Kawa, Keisei ^{[17
,18
]}

Kodera, Yoshihisa ^{[19
]}

Kato, Shunichi ^{[20
]}

机构：

[1] Nagoya Univ, Grad Sch Med, Dept HSCT Data Management Biostat, Nagoya, Aichi 4610047, Japan

[2] Aichi Canc Ctr Hosp, Dept Hematol & Cell Therapy, Nagoya, Aichi 464, Japan

[3] Univ Tokyo, Inst Med Sci, Dept Cell Proc & Transfus, Res Hosp, Tokyo, Japan

[4] Tokyo Cord Blood Bank, Tokyo, Japan

[5] Toranomon Gen Hosp, Dept Hematol, Tokyo, Japan

[6] Univ Tokyo, Inst Med Sci, Dept Mol Therapy, Tokyo, Japan

[7] Hyogo Coll Med, Dept Transfus Med, Nishinomiya, Hyogo 6638501, Japan

[8] Tokyo Metropolitan Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Div Hematol, Tokyo, Japan

[9] Tokyo Metropolitan Tama Med Ctr, Dept Transfus Med, Tokyo, Japan

[10] Sapporo Hokuyu Hosp, Dept Hematol, Sapporo, Hokkaido, Japan

[11] Natl Canc Ctr, Hematopoiet Stem Cell Transplantat Unit, Tokyo, Japan

[12] Hokkaido Red Cross Blood Ctr, Sapporo, Hokkaido, Japan

[13] Japanese Red Cross Tokyo Blood Ctr, Tokyo, Japan

[14] Keio Univ, Sch Med, Dept Med, Div Hematol, Tokyo 160, Japan

[15] Ibaraki Childrens Hosp, Mito, Ibaraki, Japan

[16] Aichi Canc Ctr Hosp, Div Epidemiol & Prevent, Nagoya, Aichi 464, Japan

[17] Osaka Med Ctr, Izumi, Japan

[18] Res Inst Maternal & Child Hlth, Izumi, Japan

[19] Japanese Red Cross Nagoya First Hosp, BMT Ctr, Nagoya, Aichi, Japan

[20] Tokai Univ, Sch Med, Dept Cell Transplantat & Regenerat Med, Isehara, Kanagawa 25911, Japan

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2012年 / 18卷 / 05期

关键词：

Unrelated cord blood transplantation; HLA-mismatched unrelated bone marrow transplantation; HEMATOPOIETIC-CELL TRANSPLANTATION; VERSUS-HOST-DISEASE; DONOR-PROGRAM; GRAFT; OUTCOMES; ALLELE; TACROLIMUS; PREVENTION; RECIPIENTS; IMPACT;

D O I：

10.1016/j.bbmt.2011.10.008

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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-DRBI-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-DRBI-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-DRBI-mismatched or other 7 of 8 UBMT. Biol Blood Marrow Transplant 18: 780-787 (2012) (C) 2012 American Society for Blood and Marrow Transplantation

引用

页码：780 / 787

页数：8

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