title: Comparable long-term outcome of unrelated cord blood transplantation with related bone marrow or peripheral blood stem cell transplantation in patients aged 45 years or older with hematologic malignancies after myeloablative conditioning.
abstract: We investigated whether bone marrow or peripheral blood stem cells from older sibling donors or cord blood from unrelated donors provided a better outcome in allogeneic hematopoietic stem cell transplantation for relatively older patients who were candidates for myeloablative conditioning. Clinical outcomes of 97 patients aged 45 years or older with hematologic malignancies who received unrelated cord blood transplantation (CBT) (n = 66) or bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT) from related donors (n = 31) were compared. The cumulative incidences of grades III to IV acute and extensive chronic graft-versus-host diseases were similar between both groups. Although transplant-related mortality was significantly lower after CBT compared with BMT/PBSCT from related donors (hazard ratio [HR], .29, P = .04), overall mortality (HR, .72, P = .47) and relapse (HR, 2.02, P = .23) were not significantly different after CBT and BMT/PBSCT from related donors. These data suggest that CBT could be as safe and effective as BMT/PBSCT from older related donors for relatively older patients when it is used as a primary unrelated stem cell source.
authors.affiliation: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan. Electronic address: tkonuma@ims.u-tokyo.ac.jp.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Konuma
authors.affiliation: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Hematology/Oncology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Ooi
authors.affiliation: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Oiwa-Monna
authors.affiliation: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: Toyotaka
authors.initials: T
authors.lastname: Kawamata
authors.affiliation: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: Arinobu
authors.initials: A
authors.lastname: Tojo
authors.affiliation: Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D019337:Hematologic Neoplasms / Q000601:surgery* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D061349:Unrelated Donors
keywords: Bone marrow transplantation; Cord blood transplantation; Donor age; Peripheral blood stem cell transplantation; Related donor