title: Effect of graft source on mismatched unrelated donor hemopoietic stem cell transplantation after reduced intensity conditioning.
abstract: This retrospective report compared the results of graft source on outcome after allogeneic stem cell transplantation (allo-SCT) in patients with hematologic malignancies receiving a reduced intensity conditioning (RIC) regimen. A total of 152 patients received either a RIC allo-SCT using a 9/10 mismatched unrelated donor (MisMUD, n=42) or a double unrelated umbilical cord blood (dUCB, n=110) graft. With a median follow-up of 30.3 months, the cumulative incidence of non-relapse mortality was 26% in the dUCB group versus 24% in the MisMUD group (P=0.95). Grade 3-4 acute graft-versus-host disease (GVHD) incidence was 19.7% in the dUCB group versus 21.4% in the MisMUD group (P=0.83). The cumulative incidence of extensive chronic GVHD at 2 years was 6.4% in the dUCB group versus 21.4% in the MisMUD group (P=0.02). The Kaplan-Meier estimate of overall survival at 2 years was comparable between both groups (52.3% (95% confidence interval (CI), 42.1-61.5%) in the dUCB group versus 47.9% (95% CI, 31.6-62.4%) in the MisMUD group, P=0.55). Progression-free survival at 2 years was 43.3% (95% CI, 33.7-52.5%) in the dUCB group versus 38.3% (95% CI, 23.2-53.3%) in the MisMUD group (P=0.55). These data suggest that dUCB is a valid alternative graft source with significantly less chronic GVHD compared with MisMUD in the setting of RIC allo-SCT.
authors.affiliation: 1] Centre Hospitalier et Universitaire (CHU) de Nantes, Service d'Hématologie Clinique, Nantes, France [2] INSERM CRNCA UMR 892, Université de Nantes, Faculté de Médecine, Nantes, France.
authors.forename: F
authors.initials: F
authors.lastname: Malard
authors.forename: S
authors.initials: S
authors.lastname: Fürst
authors.forename: M
authors.initials: M
authors.lastname: Loirat
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.forename: J
authors.initials: J
authors.lastname: El-Cheikh
authors.forename: T
authors.initials: T
authors.lastname: Guillaume
authors.forename: J
authors.initials: J
authors.lastname: Delaunay
authors.forename: S
authors.initials: S
authors.lastname: Le Gouill
authors.forename: P
authors.initials: P
authors.lastname: Moreau
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control*; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D055815:Young Adult