title: Reduced-intensity hematopoietic cell transplantation in older patients with AML/MDS: umbilical cord blood is a feasible option for patients without HLA-matched sibling donors.
abstract: Umbilical cord blood (UCB) has increased access to hematopoietic cell transplantation (HCT) for patients without HLA-matched sibling donors (MSD). We compared outcomes of HCT using MSD (N=38) or UCB (N=60) among older patients (age ≥ 55 years) with AML or myelodysplastic syndromes (MDS). All patients received a reduced intensity regimen consisting of CY, fludarabine and 200 cGy TBI. Median age at HCT was 63 years for MSD and 61 years for UCB recipients. Among UCB recipients, 95% received two UCB units and 88% received 1-2 locus HLA-mismatched units to optimize cell dose. OS at 3-years was 37% for MSD and 31% for UCB recipients (P=0.21). On multivariate analysis, donor source (MSD vs UCB) did not impact risks of OS, leukemia-free survival and relapse or treatment-related mortality. UCB is feasible as an alternative donor source for reduced-intensity conditioning HCT among older patients with AML and MDS who do not have a suitable MSD.
authors: Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455, USA. majha001@umn.edu
authors: N S
authors: NS
authors: Majhail
authors: C G
authors: CG
authors: Brunstein
authors: R
authors: R
authors: Shanley
authors: K
authors: K
authors: Sandhu
authors: B
authors: B
authors: McClune
authors: B
authors: B
authors: Oran
authors: E D
authors: ED
authors: Warlick
authors: J E
authors: JE
authors: Wagner
authors: D J
authors: DJ
authors: Weisdorf
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