Skip to main content
Journal cover image

Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis.

Publication ,  Journal Article
Eapen, M; Rocha, V; Sanz, G; Scaradavou, A; Zhang, M-J; Arcese, W; Sirvent, A; Champlin, RE; Chao, N; Gee, AP; Isola, L; Laughlin, MJ ...
Published in: Lancet Oncol
July 2010

BACKGROUND: Umbilical-cord blood (UCB) is increasingly considered as an alternative to peripheral blood progenitor cells (PBPCs) or bone marrow, especially when an HLA-matched adult unrelated donor is not available. We aimed to determine the optimal role of UCB grafts in transplantation for adults with acute leukaemia, and to establish whether current graft-selection practices are appropriate. METHODS: We used Cox regression to retrospectively compare leukaemia-free survival and other outcomes for UCB, PBPC, and bone marrow transplantation in patients aged 16 years or over who underwent a transplant for acute leukaemia. Data were available on 1525 patients transplanted between 2002 and 2006. 165 received UCB, 888 received PBPCs, and 472 received bone marrow. UCB units were matched at HLA-A and HLA-B at antigen level, and HLA-DRB1 at allele level (n=10), or mismatched at one (n=40) or two (n=115) antigens. PBPCs and bone-marrow grafts from unrelated adult donors were matched for allele-level HLA-A, HLA-B, HLA-C, and HLA-DRB1 (n=632 and n=332, respectively), or mismatched at one locus (n=256 and n=140, respectively). FINDINGS: Leukaemia-free survival in patients after UCB transplantation was comparable with that after 8/8 and 7/8 allele-matched PBPC or bone-marrow transplantation. However, transplant-related mortality was higher after UCB transplantation than after 8/8 allele-matched PBPC recipients (HR 1.62, 95% CI 1.18-2.23; p=0.003) or bone-marrow transplantation (HR 1.69, 95% CI 1.19-2.39; p=0.003). Grades 2-4 acute and chronic graft-versus-host disease (GvHD) were lower in UCB recipients compared with allele-matched PBPC (HR 0.57, 95% 0.42-0.77; p=0.002 and HR 0.38, 0.27-0.53; p=0.003, respectively), while the incidence of chronic, but not acute GvHD, was lower after UCB than after 8/8 allele-matched bone-marrow transplantation (HR 0.63, 0.44-0.90; p=0.01). INTERPRETATION: These data support the use of UCB for adults with acute leukaemia when there is no HLA-matched unrelated adult donor available, and when a transplant is needed urgently.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Lancet Oncol

DOI

EISSN

1474-5488

Publication Date

July 2010

Volume

11

Issue

7

Start / End Page

653 / 660

Location

England

Related Subject Headings

  • Transplantation, Homologous
  • Retrospective Studies
  • Proportional Hazards Models
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Peripheral Blood Stem Cell Transplantation
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Leukemia, Myeloid, Acute
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Eapen, M., Rocha, V., Sanz, G., Scaradavou, A., Zhang, M.-J., Arcese, W., … National Cord Blood Program of the New York Blood Center, . (2010). Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis. Lancet Oncol, 11(7), 653–660. https://doi.org/10.1016/S1470-2045(10)70127-3
Eapen, Mary, Vanderson Rocha, Guillermo Sanz, Andromachi Scaradavou, Mei-Jie Zhang, William Arcese, Anne Sirvent, et al. “Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis.Lancet Oncol 11, no. 7 (July 2010): 653–60. https://doi.org/10.1016/S1470-2045(10)70127-3.
Eapen M, Rocha V, Sanz G, Scaradavou A, Zhang M-J, Arcese W, et al. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis. Lancet Oncol. 2010 Jul;11(7):653–60.
Eapen, Mary, et al. “Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis.Lancet Oncol, vol. 11, no. 7, July 2010, pp. 653–60. Pubmed, doi:10.1016/S1470-2045(10)70127-3.
Eapen M, Rocha V, Sanz G, Scaradavou A, Zhang M-J, Arcese W, Sirvent A, Champlin RE, Chao N, Gee AP, Isola L, Laughlin MJ, Marks DI, Nabhan S, Ruggeri A, Soiffer R, Horowitz MM, Gluckman E, Wagner JE, Center for International Blood and Marrow Transplant Research, Acute Leukemia Working Party Eurocord (the European Group for Blood Marrow Transplantation), National Cord Blood Program of the New York Blood Center. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis. Lancet Oncol. 2010 Jul;11(7):653–660.
Journal cover image

Published In

Lancet Oncol

DOI

EISSN

1474-5488

Publication Date

July 2010

Volume

11

Issue

7

Start / End Page

653 / 660

Location

England

Related Subject Headings

  • Transplantation, Homologous
  • Retrospective Studies
  • Proportional Hazards Models
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Peripheral Blood Stem Cell Transplantation
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Leukemia, Myeloid, Acute
  • Humans