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Unrelated cord blood compared with haploidentical grafts in patients with hematological malignancies.
Cancer. 2015 Jun 01; 121(11):1809-16.C

Abstract

BACKGROUND

Alternative donors, such as unrelated umbilical cord blood (UCB) and related haploidentical (haplo) donors, are more and more frequently searched for and used for patients who are candidates for allogeneic hematopoietic stem cell transplantation but are without a suitable related or unrelated donor. The aim of the current retrospective study was to compare the outcome of patients after haplo and UCB grafts prepared using a nonmyeloablative conditioning regimen.

METHODS

A total of 150 adult patients with high-risk hematologic diseases who underwent allogeneic hematopoietic stem cell transplantation from alternative donors at 2 centers (Paoli-Calmettes Institute [Marseille, France] and Humanitas Cancer Center [Milan, Italy]) were analyzed. Sixty-nine patients had haplo donors and 81 patients had UCB donors.

RESULTS

The cumulative incidence of nonrecurrence mortality at 1 year was 23% in the UCB group versus 17% in the haplo group (P = .39). The incidence of grade 2 to 4 acute graft-versus-host disease and extensive chronic graft-versus-host disease in the UCB group versus the haplo group was 52% versus 29% (P = .05) and 12% versus 6% (P<.0001), respectively. The overall survival rate at 2 years was 45% in the UCB group (95% confidence interval [95% CI], 34%-56%) versus 69% in the haplo group (95% CI, 58%-80%) (P = .10). The progression-free survival rate at 2 years was 36% in the UCB group (95% CI, 25%-47%) versus 65% in the haplo group (95% CI, 53%-77%) (P = .01).

CONCLUSIONS

The results of the current study suggest that for patients with high-risk hematological diseases without a related or unrelated donor, haploidentical transplants are a promising alternative option that deserves further investigation.

Authors+Show Affiliations

Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France. Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.Humanitas Cancer Center, Milan, Italy.Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France. Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.Humanitas Cancer Center, Milan, Italy.Humanitas Cancer Center, Milan, Italy.Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France. Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.Humanitas Cancer Center, Milan, Italy.Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France. Cellular Therapy Center, Paoli-Calmettes Institute, Marseille, France.Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France. Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France. Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France. Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France. Aix-Marseille University, Marseille, France.Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France. Aix-Marseille University, Marseille, France. Cancer Research Center of Marseille, Marseille, France.Aix-Marseille University, Marseille, France.Cellular Therapy Center, Paoli-Calmettes Institute, Marseille, France. Aix-Marseille University, Marseille, France. Cancer Research Center of Marseille, Marseille, France.Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France. Humanitas Cancer Center, Milan, Italy.Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France. Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France. Aix-Marseille University, Marseille, France. Cancer Research Center of Marseille, Marseille, France.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25649994

Citation

El-Cheikh, Jean, et al. "Unrelated Cord Blood Compared With Haploidentical Grafts in Patients With Hematological Malignancies." Cancer, vol. 121, no. 11, 2015, pp. 1809-16.
El-Cheikh J, Crocchiolo R, Furst S, et al. Unrelated cord blood compared with haploidentical grafts in patients with hematological malignancies. Cancer. 2015;121(11):1809-16.
El-Cheikh, J., Crocchiolo, R., Furst, S., Bramanti, S., Sarina, B., Granata, A., Vai, A., Lemarie, C., Faucher, C., Mohty, B., Harbi, S., Bouabdallah, R., Vey, N., Santoro, A., Chabannon, C., Castagna, L., & Blaise, D. (2015). Unrelated cord blood compared with haploidentical grafts in patients with hematological malignancies. Cancer, 121(11), 1809-16. https://doi.org/10.1002/cncr.29271
El-Cheikh J, et al. Unrelated Cord Blood Compared With Haploidentical Grafts in Patients With Hematological Malignancies. Cancer. 2015 Jun 1;121(11):1809-16. PubMed PMID: 25649994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unrelated cord blood compared with haploidentical grafts in patients with hematological malignancies. AU - El-Cheikh,Jean, AU - Crocchiolo,Roberto, AU - Furst,Sabine, AU - Bramanti,Stefania, AU - Sarina,Barbara, AU - Granata,Angela, AU - Vai,Andrea, AU - Lemarie,Claude, AU - Faucher,Catherine, AU - Mohty,Bilal, AU - Harbi,Samia, AU - Bouabdallah,Reda, AU - Vey,Norbert, AU - Santoro,Armando, AU - Chabannon,Christian, AU - Castagna,Luca, AU - Blaise,Didier, Y1 - 2015/02/03/ PY - 2014/10/21/received PY - 2014/11/28/revised PY - 2014/12/11/accepted PY - 2015/2/5/entrez PY - 2015/2/5/pubmed PY - 2015/8/26/medline KW - allogeneic hematopoietic stem cell transplantation KW - haploidentical donor KW - high-risk hematological diseases KW - nonmyeloablative conditioning regimen KW - unrelated umbilical cord blood SP - 1809 EP - 16 JF - Cancer JO - Cancer VL - 121 IS - 11 N2 - BACKGROUND: Alternative donors, such as unrelated umbilical cord blood (UCB) and related haploidentical (haplo) donors, are more and more frequently searched for and used for patients who are candidates for allogeneic hematopoietic stem cell transplantation but are without a suitable related or unrelated donor. The aim of the current retrospective study was to compare the outcome of patients after haplo and UCB grafts prepared using a nonmyeloablative conditioning regimen. METHODS: A total of 150 adult patients with high-risk hematologic diseases who underwent allogeneic hematopoietic stem cell transplantation from alternative donors at 2 centers (Paoli-Calmettes Institute [Marseille, France] and Humanitas Cancer Center [Milan, Italy]) were analyzed. Sixty-nine patients had haplo donors and 81 patients had UCB donors. RESULTS: The cumulative incidence of nonrecurrence mortality at 1 year was 23% in the UCB group versus 17% in the haplo group (P = .39). The incidence of grade 2 to 4 acute graft-versus-host disease and extensive chronic graft-versus-host disease in the UCB group versus the haplo group was 52% versus 29% (P = .05) and 12% versus 6% (P<.0001), respectively. The overall survival rate at 2 years was 45% in the UCB group (95% confidence interval [95% CI], 34%-56%) versus 69% in the haplo group (95% CI, 58%-80%) (P = .10). The progression-free survival rate at 2 years was 36% in the UCB group (95% CI, 25%-47%) versus 65% in the haplo group (95% CI, 53%-77%) (P = .01). CONCLUSIONS: The results of the current study suggest that for patients with high-risk hematological diseases without a related or unrelated donor, haploidentical transplants are a promising alternative option that deserves further investigation. SN - 1097-0142 UR - https://www.unboundmedicine.com/medline/citation/25649994/Unrelated_cord_blood_compared_with_haploidentical_grafts_in_patients_with_hematological_malignancies_ L2 - https://doi.org/10.1002/cncr.29271 DB - PRIME DP - Unbound Medicine ER -