Single Cord Blood Transplantation Versus HLA-Haploidentical-related Donor Transplantation Using Posttransplant Cyclophosphamide in Patients With Hematological Malignancies.

Transplantation 2022 Jun 01

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Unrelated cord blood (UCB) and haploidentical related donor transplantation using posttransplant cyclophosphamide (PTCy-haplo) have become alternative options to treat patients with hematological malignancies without a HLA-matched donor. We conducted a retrospective study using registry data from the Kyoto Stem Cell Transplantation Group for patients with hematological malignancies who received their first allogeneic hematopoietic cell transplantation using a single UCB unit (n = 460) or PTCy-haplo (N = 57) between 2013 and 2019. We found that overall survival in the UCB group was comparable to that in the PTCy-haplo group (hazard ratio, 1.00; 95% confidence interval, 0.66-1.52), although neutrophil and platelet engraftment were significantly delayed. Nonrelapse mortality risk and the incidence of graft-versus-host disease in the UCB group were also comparable to those in the PTCy-haplo group. Although the relapse risk was similar between the UCB group and the PTCy-haplo group regardless of the disease risk, acute myeloid leukemia patients benefit from UCB transplant with a significantly lower relapse rate (hazard ratio, 0.38; 95% confidence interval, 0.18-0.76). UCB transplant gives outcomes comparable to PTCy-haplo transplant, and both UCB and PTCy-haplo units are suitable as alternative donor sources for patients without an HLA-matched sibling or unrelated donor. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Citation

Fumiya Wada, Junya Kanda, Satoshi Yoshioka, Takayuki Ishikawa, Takashi Akasaka, Yasunori Ueda, Hirokazu Hirata, Yasuyuki Arai, Kazuhiro Yago, Naoyuki Anzai, Mitsumasa Watanabe, Takashi Ikeda, Akihito Yonezawa, Kazunori Imada, Mitsuru Itoh, Toshiyuki Kitano, Tomoharu Takeoka, Masakatsu Hishizawa, Masaharu Nohgawa, Nobuyoshi Arima, Kousuke Asagoe, Tadakazu Kondo, Akifumi Takaori-Kondo, Kyoto Stem Cell Transplantation Group (KSCTG). Single Cord Blood Transplantation Versus HLA-Haploidentical-related Donor Transplantation Using Posttransplant Cyclophosphamide in Patients With Hematological Malignancies. Transplantation. 2022 Jun 01;106(6):1279-1287