title: Comparison of Outcomes of 8/8 and 7/8 Allele-Matched Unrelated Bone Marrow Transplantation and Single-Unit Cord Blood Transplantation in Adults with Acute Leukemia.
abstract: To investigate an up-to-date alternative donor selection strategy, we compared the transplantation outcomes of 8/8 and 7/8 allele-matched unrelated bone marrow transplantation (UBMT) with those of umbilical cord blood transplantation (UCBT) and redefined the role of UCBT with extended analysis. Using Cox and competing risk regression analyses, we analyzed the transplantation outcomes in adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). A total of 2472 first myeloablative transplantations between 2000 and 2010 were included (8/8 UBMT, 1001; 7/8 UBMT, 656; UCBT, 815). For acute and chronic graft-versus-host disease (GVHD) and nonrelapse mortality (NRM), we applied the combined analyses including both AML and ALL data. In the multivariate analyses, severe acute GVHD and NRM after UCBT were comparable with 8/8 UBMT, whereas those after 7/8 UBMT were significantly higher. The incidence of extensive chronic GVHD was significantly lower with UCBT compared with after 8/8 and 7/8 UBMT. With adjusted analyses for AML, UCBT and 8/8 UBMT showed similar overall survival (OS), whereas 7/8 UBMT showed inferior OS. For ALL, we found no significant difference in OS among the 3 groups. Cord blood may be the first choice alternative to 8/8 UBMT for both AML and ALL.
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: tseit@med.nagoya-u.ac.jp.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Terakura
authors.affiliation: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Atsuta
authors.affiliation: Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tsukada
authors.affiliation: Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.affiliation: Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
authors.forename: Yuho
authors.initials: Y
authors.lastname: Najima
authors.affiliation: Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Uchida
authors.affiliation: Division of Molecular Therapy, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Cell Processing and Transfusion, Research Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nagamura-Inoue
authors.affiliation: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.affiliation: Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D016026:Bone Marrow Transplantation / Q000379:methods*; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bone marrow transplantation; Graft source; Umbilical cord blood transplantation; Unrelated volunteer donor