title: Unrelated cord blood compared with haploidentical grafts in patients with hematological malignancies.
abstract: BACKGROUND
  Alternative donors, such as unrelated umbilical cord blood (UCB) and related haploidentical (haplo) donors, are more and more frequently searched for and used for patients who are candidates for allogeneic hematopoietic stem cell transplantation but are without a suitable related or unrelated donor. The aim of the current retrospective study was to compare the outcome of patients after haplo and UCB grafts prepared using a nonmyeloablative conditioning regimen.
  
  
  METHODS
  A total of 150 adult patients with high-risk hematologic diseases who underwent allogeneic hematopoietic stem cell transplantation from alternative donors at 2 centers (Paoli-Calmettes Institute [Marseille, France] and Humanitas Cancer Center [Milan, Italy]) were analyzed. Sixty-nine patients had haplo donors and 81 patients had UCB donors.
  
  
  RESULTS
  The cumulative incidence of nonrecurrence mortality at 1 year was 23% in the UCB group versus 17% in the haplo group (P = .39). The incidence of grade 2 to 4 acute graft-versus-host disease and extensive chronic graft-versus-host disease in the UCB group versus the haplo group was 52% versus 29% (P = .05) and 12% versus 6% (P<.0001), respectively. The overall survival rate at 2 years was 45% in the UCB group (95% confidence interval [95% CI], 34%-56%) versus 69% in the haplo group (95% CI, 58%-80%) (P = .10). The progression-free survival rate at 2 years was 36% in the UCB group (95% CI, 25%-47%) versus 65% in the haplo group (95% CI, 53%-77%) (P = .01).
  
  
  CONCLUSIONS
  The results of the current study suggest that for patients with high-risk hematological diseases without a related or unrelated donor, haploidentical transplants are a promising alternative option that deserves further investigation.
authors: Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France.|Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.
authors: Jean
authors: J
authors: El-Cheikh
authors: Humanitas Cancer Center, Milan, Italy.
authors: Roberto
authors: R
authors: Crocchiolo
authors: Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France.|Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.
authors: Sabine
authors: S
authors: Furst
authors: Humanitas Cancer Center, Milan, Italy.
authors: Stefania
authors: S
authors: Bramanti
authors: Humanitas Cancer Center, Milan, Italy.
authors: Barbara
authors: B
authors: Sarina
authors: Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France.|Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.
authors: Angela
authors: A
authors: Granata
authors: Humanitas Cancer Center, Milan, Italy.
authors: Andrea
authors: A
authors: Vai
authors: Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.|Cellular Therapy Center, Paoli-Calmettes Institute, Marseille, France.
authors: Claude
authors: C
authors: Lemarie
authors: Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France.|Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.
authors: Catherine
authors: C
authors: Faucher
authors: Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France.|Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.
authors: Bilal
authors: B
authors: Mohty
authors: Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France.|Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.|Aix-Marseille University, Marseille, France.
authors: Samia
authors: S
authors: Harbi
authors: Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.
authors: Reda
authors: R
authors: Bouabdallah
authors: Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.|Aix-Marseille University, Marseille, France.|Cancer Research Center of Marseille, Marseille, France.
authors: Norbert
authors: N
authors: Vey
authors: Aix-Marseille University, Marseille, France.
authors: Armando
authors: A
authors: Santoro
authors: Cellular Therapy Center, Paoli-Calmettes Institute, Marseille, France.|Aix-Marseille University, Marseille, France.|Cancer Research Center of Marseille, Marseille, France.
authors: Christian
authors: C
authors: Chabannon
authors: Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France.|Humanitas Cancer Center, Milan, Italy.
authors: Luca
authors: L
authors: Castagna
authors: Transplantation and Cellular Therapy Unit (U2T), Paoli-Calmettes Institute, Marseille, France.|Department of Hematology and Medical Oncology, Paoli-Calmettes Institute, Marseille, France.|Aix-Marseille University, Marseille, France.|Cancer Research Center of Marseille, Marseille, France.
authors: Didier
authors: D
authors: Blaise
mesh_terms: D000328:Adult; D000368:Aged; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D005312:Fetal Blood; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D055815:Young Adult
keywords: allogeneic hematopoietic stem cell transplantation; haploidentical donor; high-risk hematological diseases; nonmyeloablative conditioning regimen; unrelated umbilical cord blood