title: Haplo-Cord transplantation compared to haploidentical transplantation with post-transplant cyclophosphamide in patients with AML.
abstract: For patients with AML, the best alternative donor remains to be defined. We analyze outcomes of patients who underwent myeloablative umbilical cord blood or haploidentical hemopoietic stem cell transplantation (HSCT) in Spain. Fifty-one patients underwent single umbilical cord blood transplantation supported by a third party donor (Haplo-Cord) between 1999 and 2012, and 36 patients received an haploidentical HSCT with post-transplant cyclophosphamide (PTCY-haplo) between 2012 and 2014 in GETH centers. The Haplo-Cord cohort included a higher proportion of patients with high disease risk index and use of TBI in the conditioning regimen, and hematopoietic cell transplantation-age Comorbidity Age Index was higher in PTCY-haplo patients. Cumulative incidence of neutrophil engraftment was 97% in the Haplo-Cord and 100% in the PTCY-haplo group, achieved in a median of 12 and 17 days, respectively (P=0.01). Grade II-IV acute GvHD rate was significantly higher in the PTCY-haplo group (9.8% vs 29%, P=0.02) as well as chronic GvHD rates (20% vs 38%, P=0.03). With a median follow-up of 61 months for the Haplo-Cord group and 26 months for the PTCY-haplo cohort, overall survival at 2 years was 55% and 59% (P=0.66), event-free survival was 45% vs 56% (P=0.46), relapse rate was 27% vs 21% (P=0.79), and non-relapse mortality was 17% vs 23% (P=0.54), respectively. In this multicenter experience, Haplo-Cord and PTCY-haplo HSCT offer valid alternatives for patients with AML. Neutrophil engraftment was faster in the Haplo-Cord cohort, with similar survival rates, with higher GvHD rates after haploidentical HSCT.
authors.affiliation: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.|Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Kwon
authors.affiliation: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Bautista
authors.affiliation: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.|Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Balsalobre
authors.affiliation: Department of Hematology, Hospital Duran i Reynals, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Sánchez-Ortega
authors.affiliation: Department of Hematology, Hospital U. La Fe, Valencia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Montesinos
authors.affiliation: Department of Hematology, Hospital Universitario Marqués Valdecilla, Santander, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Bermúdez
authors.affiliation: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: de Laiglesia
authors.affiliation: Department of Hematology, Hospital Universitario Ramon y Cajal, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Herrera
authors.affiliation: Department of Hematology, Hospital Universitario Reina Sofia, Córdoba, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.affiliation: Department of Hematology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: K
authors.initials: K
authors.lastname: Humala
authors.affiliation: Department of Hematology, Complejo Hospitalario Navarra, Pamplona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Zabalza
authors.affiliation: Department of Hematology, Hospital Universitario Gran Canaria Dr Negrin, Las Palmas, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Torres
authors.affiliation: Department of Hematology, Hospital Universitario Son Epases, Mallorca, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Bento
authors.affiliation: Department of Hematology, Hospital Clínico Universitario Salamanca, Murcia, Spain.
authors.forename: L L
authors.initials: LL
authors.lastname: Corral
authors.affiliation: Department of Hematology, Hospital General Universitario Morales Meseguer, Murcia, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Heras
authors.affiliation: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.|Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Serrano
authors.affiliation: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.|Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Buño
authors.affiliation: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.|Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Anguita
authors.affiliation: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Regidor
authors.affiliation: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Duarte
authors.affiliation: Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Cabrera
authors.affiliation: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.|Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.|Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Gayoso
authors.affiliation: Department of Hematology, Hospital General Universitario Gregorio Marañon, Madrid, Spain.|Department of Hematology, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.|Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Diez-Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D003520:Cyclophosphamide / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods; D000075442:Transplantation, Haploidentical / Q000379:methods* / Q000401:mortality; D055815:Young Adult
chemical_list: D003520:Cyclophosphamide