title: Factors associated with outcomes of unrelated cord blood transplant: guidelines for donor choice.
abstract: OBJECTIVE
  Optimizing cord blood donor selection based mainly on cell dose and human leukocyte antigen (HLA) disparities may further improve results of unrelated cord blood transplants (UCBT).
  
  
  RESULTS
  We analyzed 550 UCBTs for hematologic malignancies reported to the Eurocord Registry. Main outcomes and prognostic factors were analyzed in univariable and multivariable analyses incorporating center and period effects and using death and relapse as competitive risks for nonfatal endpoints. Nucleated cell (NC) dose before freezing and number of HLA disparities had a significant influence on outcome. Cumulative incidence (CI) of neutrophil and platelet recovery was associated with the number of HLA mismatches, number of NC before freezing, and use of granulocyte colony-stimulating factor. Coexistence of HLA class I and II disparities and high CD34 cell dose in the graft were associated with graft-vs-host disease grades III-IV. CI of disease relapse was higher in matched transplants showing a graft-vs-leukemia effect increased in HLA-mismatched transplants. Overall 3-year survival was 34.4%. Prognostic factors for survival were recipient age, gender, and disease status.
  
  
  CONCLUSIONS
  Our results provide indications for a better choice of cord blood units according to cord blood cell content and HLA.
authors.affiliation: Bone Marrow Transplant Unit and Eurocord Registry, Laboratory of Clinical Research on Cell Therapy, Saint Louis Hospital AP-HP University Paris VII, Paris, France. elaine.gluckman@sls.ap-hop-paris.fr
authors.forename: Eliane
authors.initials: E
authors.lastname: Gluckman
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
authors.forename: William
authors.initials: W
authors.lastname: Arcese
authors.forename: Gérard
authors.initials: G
authors.lastname: Michel
authors.forename: Guillermo
authors.initials: G
authors.lastname: Sanz
authors.forename: Ka-Wah
authors.initials: KW
authors.lastname: Chan
authors.forename: Tsuneo A
authors.initials: TA
authors.lastname: Takahashi
authors.forename: Juan
authors.initials: J
authors.lastname: Ortega
authors.forename: Alexandra
authors.initials: A
authors.lastname: Filipovich
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Asano
authors.forename: Franca
authors.initials: F
authors.lastname: Fagioli
authors.forename: Marcus
authors.initials: M
authors.lastname: Vowels
authors.forename: Anne
authors.initials: A
authors.lastname: Sirvent
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Laporte
authors.forename: Karin
authors.initials: K
authors.lastname: Tiedemann
authors.forename: Sergio
authors.initials: S
authors.lastname: Amadori
authors.forename: Manuel
authors.initials: M
authors.lastname: Abecassis
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordigoni
authors.forename: Blanca
authors.initials: B
authors.lastname: Diez
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Shaw
authors.forename: Ajay
authors.initials: A
authors.lastname: Vora
authors.forename: Maurizio
authors.initials: M
authors.lastname: Caniglia
authors.forename: Federico
authors.initials: F
authors.lastname: Garnier
authors.forename: Irina
authors.initials: I
authors.lastname: Ionescu
authors.forename: Joan
authors.initials: J
authors.lastname: Garcia
authors.forename: Gesine
authors.initials: G
authors.lastname: Koegler
authors.forename: Paolo
authors.initials: P
authors.lastname: Rebulla
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D001772:Blood Cell Count; D002648:Child; D002675:Child, Preschool; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects / Q000592:standards / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D020544:Graft vs Leukemia Effect / Q000276:immunology; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D006680:HLA Antigens / Q000276:immunology; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D006648:Histocompatibility; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D015993:Life Tables; D008297:Male; D009436:Neural Tube Defects / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000401:mortality / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D006680:HLA Antigens; D016179:Granulocyte Colony-Stimulating Factor