Similar survival, but better quality of life after myeloablative transplantation using unrelated cord blood vs matched sibling donors in adults with hematologic malignancies.
This study included data from 185 consecutively treated patients, 16 years of age or older, who underwent myeloablative transplantation using unrelated umbilical cord blood (UCB) (UCB transplantation (UCBT), n=70) or HLA-identical sibling donor peripheral blood stem cells alone or combined with bone marrow (BMT/PBSCT, n=115) from October 2001 to December 2012. All patients received myeloablative regimens, cyclosporin A plus mycophenolate mofetil as prophylaxis for GVHD, and similar supportive care. Although hematopoietic recovery was significantly delayed after UCBT, the rate of neutrophil engraftment was comparable. The median follow-up was 53 months (range, 15-136 months) for BMT/peripheral blood SCT (PBSCT) recipients and 35 months (range, 10-123 months) for UCBT recipients. There were no significant differences in the cumulative incidence of grades III to IV acute GVHD, relapse rate, or 3-year probabilities of disease-free survival between patients receiving UCBT and those receiving BMT/PBSCT. However, the cumulative incidence of chronic and extensive chronic GVHD was lower in UCBT recipients. The rates of long-term survivors returning to school or work and off immunosuppressive therapy were significantly higher after UCBT, which indicated that long-term survivors who underwent UCBT had a higher quality of life.
1] Institute of Clinical Pharmacology, Anhui Medical University, Anhui, China [2] Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
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HL
Liu
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
Z-M
ZM
Sun
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
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LQ
Geng
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
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XB
Wang
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
K-Y
KY
Ding
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
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J
Tong
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
B-L
BL
Tang
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
C-Y
CY
Zhou
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
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W
Yao
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
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CC
Zheng
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
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KD
Song
Department of Hematology of Anhui Provincial Hospital, Anhui Medical University, Anhui, China.
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XY
Zhu
Institute of Clinical Pharmacology, Anhui Medical University, Anhui, China.
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W
Wei
1] Institute of Clinical Pharmacology, Anhui Medical University, Anhui, China [2] Laboratory of Molecular Biology and Department of Biochemistry; Anhui Medical University, Anhui, China [3] Key Laboratory of Anti-inflammatory and Immunological Pharmacology, Ministry of Education, Anhui Medical University, Anhui, China [4] Key Laboratory of Gene Resource Utilization for Severe Diseases of Anhui Province, Anhui Medical University, Anhui, China.
Y
Y
Wang
D000293:Adolescent; D000328:Adult; D064591:Allografts; D036101:Cord Blood Stem Cell Transplantation; D016572:Cyclosporine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy; D006801:Humans; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D011788:Quality of Life; D035781:Siblings; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods*; D061349:Unrelated Donors
D016572:Cyclosporine; D009173:Mycophenolic Acid