Single umbilical cord blood with or without CD34+ cells from a third-party donor in adults with leukemia

• Published in: Blood advances Vol. 1; no. 15; pp. 1047 - 1055
• Main Authors: Sanz, Jaime, Kwon, Mi, Bautista, Guiomar, Sanz, Miguel A., Balsalobre, Pascual, Piñana, José Luis, Solano, Carlos, Duarte, Rafael, Ferrá, Christelle, Lorenzo, Ignacio, Martín, Carmen, Barba, Pere, Pascual, María Jesús, Martino, Rodrigo, Gayoso, Jorge, Buño, Ismael, Regidor, Carmen, de la Iglesia, Almudena, Montoro, Juan, Díez-Martín, José Luis, Sanz, Guillermo F., Cabrera, Rafael
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 27.06.2017; American Society of Hematology; Elsevier
• Subjects: Transplantation
• ISSN: 2473-9529; 2473-9537
• DOI: 10.1182/bloodadvances.2017006999

We retrospectively compared the clinical outcomes of adults with acute leukemia who received single-unit umbilical cord blood (UCB) transplantation (sUCBT) (n = 135) or stem cell transplant using coinfusion of a UCB graft with CD34+ cells from a third-party donor (Haplo-Cord) (n = 72) at different institutions within the Grupo Español de Trasplante Hematopoyético. In multivariable analysis, patients in the Haplo-Cord group showed more rapid neutrophil (hazard ratio [HR], 2.3; 95% confidence interval [CI], 1.5-3.3; P < .001) and platelet recovery (HR, 1.6; 95% CI, 1.2-2.3; P = .015) and lower incidence of chronic graft-versus-host disease (GVHD) (relative risk, 0.5; 95% CI, 0.3-0.8; P = .01). Nonrelapse mortality, relapse, disease-free survival (DFS), and GVHD/relapse-free survival were similar in the 2 groups. Regarding disease-specific outcomes, DFS in both acute myeloid leukemia (AML) and acute lymphoblastic leukemia patients was not significantly different; however, a significantly higher relapse rate was found in patients with AML treated with Haplo-Cord (HR, 2.3; 95% CI, 1-5.4; P = .04). Our study confirms that Haplo-Cord was an effective strategy to accelerate neutrophil and platelet recovery and shows that, in the context of specific treatment platforms, sUCBT and Haplo-Cord offer similar long-term outcomes. •Haplo-Cord is an effective strategy to quicken neutrophil and platelet recovery.•In specific treatment platforms, sUCBT and Haplo-Cord offer similar long-term outcomes.