Comparative Analysis of Single-Institute Transplantation From Unrelated Cord Blood and Related Adult Donors In Adults with Hematologic Malignancies.

Abstract 4570

We compared the clinical outcomes of allogeneic hematopoietic stem-cell transplantation among 126 adults with hematologic malignancies: 40 received unrelated cord blood transplantation (CBT) and 86 received related bone marrow transplantation (BMT) and/or peripheral blood stem cells transplantation (PBSCT). All patients received myeloablative transplantations which performed from 2001 through 2010.Recipients of unrelated CBT were younger (median, 23.5 vs. 30 years of age; P<0.001) and had more advanced disease at the time of transplantation (68% vs. 34%, P<0.001) than recipients of related BMT/PBSCT. All related transplants were HLA matched, whereas 77 percent of CBT grafts were HLA mismatched (P<0.001). The median number of nucleated cells infused was 0.37×10⁸ per kilogram of the recipient's body weight for CBT and 5.39×10⁸ per kilogram for BMT/PBSCT recipients (P<0.001). Neutrophil recovery was significantly delayed after CBT (median, 19 vs. 12 days post transplantation, P<0.001), however, overall engraftment rates were almost the same for both grafts. Multivariate analysis demonstrated no apparent differences in transplantation-related mortality (TRM) (33% in CBT and 21% in BMT/PBSCT recipients), relapse rate (15% in CBT and 15.1% in BMT/PBSCT recipients), the incidence of grades III to ‡W acute graft-versus-host disease (aGVHD) (7.5% in CBT and 5.8% in BMT/PBSCT recipients), 2 years disease free survival (DFS) (52.5% in CBT vs. 62.8% in BMT/PBSCT recipients) and over survival (OS) (62.5% in CBT vs. 67.4% in BMT/PBSCT recipients) between both groups, but extensive chronic GVHD (cGVHD) was lower in CBT recipients (2.5% vs. 17.4%). These data suggest that unrelated CBT could be as safe and effective as matched related BMT or mobilized PBSCT for adult patients with hematologic malignancies.