TY - JOUR
T1 - A Comparison of Outcomes for Cord Blood Transplantation and Unrelated Bone Marrow Transplantation in Adult Aplastic Anemia
AU - Japan Society for Hematopoietic Cell Transplantation
AU - Kuwatsuka, Yachiyo
AU - Kanda, Junya
AU - Yamazaki, Hirohito
AU - Mori, Takehiko
AU - Miyamura, Koichi
AU - Kako, Shinichi
AU - Uchida, Naoyuki
AU - Ohashi, Kazuteru
AU - Ozawa, Yukiyasu
AU - Takahashi, Yoshiyuki
AU - Kato, Chiaki
AU - Iwato, Koji
AU - Ishiyama, Ken
AU - Kobayashi, Hikaru
AU - Eto, Tetsuya
AU - Kahata, Kaoru
AU - Kato, Jun
AU - Miyamoto, Toshihiro
AU - Kato, Koji
AU - Mori, Shinicihro
AU - Atsuta, Yoshiko
AU - Kimura, Fumihiko
AU - Kanda, Yoshinobu
N1 - Funding Information:
This study was funded in part by JSPS KAKENHI Grant Number 26860346 from the Japan Society for the Promotion of Science.
Publisher Copyright:
© 2016 The American Society for Blood and Marrow Transplantation
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Earlier reports suggested that umbilical cord blood transplantation (UCBT) for aplastic anemia (AA) was feasible in alternative transplantation. To identify differences in outcomes of UCBT and HLA-matched or mismatched unrelated bone marrow transplantation (UBMT) in adults with AA, we analyzed registry data of the Japan Society for Hematopoietic Cell Transplantation and compared results of UCBT (n = 69) to 8/8-matched (n = 101), 7/8-matched (n = 65), or 6/8-matched (n = 37) UBMT. The transplantation period was from 2002 to 2012, and patients 16 years or older with AA were eligible. Median ages were 49, 35, 28, and 30 years for UCBT, 8/8-matched, 7/8-matched, and 6/8-matched UBMT, respectively. In multivariate analysis, risk of mortality was lower for 8/8-matched UBMT compared with that of UCBT (hazard ratio [HR], 55; 95% confidence interval [CI], 32 to .94; P = .029), adjusted for age and graft-versus-host disease (GVHD) prophylaxis, which were other associated factors. Mortality risks of 7/8-matched UBMT (HR, 55; 95% CI, 29 to 1.02) or 6/8-matched UBMT (HR, 67; 95% CI, 32 to 1.39) were not significantly different from those of UCBT. Risks of grade 3 or 4 acute and chronic GVHD were not different among the 4 groups. The most prevalent cause of death was graft failure in UCBT and 6/8-matched UBMT and infection in 8/8-matched and 7/8-matched UBMT. Under 40 years old,survival of UCBT was similar to that of UBMT (76%, 79%, 83%, and 83% for UCBT and 8/8-matched, 7/8-matched, and 6/8-matched UBMT, respectively, at 3 years), adjusted for transplantation period, which was another associated factor; however, for ages over 40 years, that of UCBT tended to be lower (47%, 64%, 64%, and 75% for UCBT, 8/8-matched, 7/8-matched, and 6/8-matched UBMT, respectively, at 3 years). To conclude, these data suggest that UCBT could be an alternative treatment option for younger adults when matched sibling or adequate UBMT donors are not available.
AB - Earlier reports suggested that umbilical cord blood transplantation (UCBT) for aplastic anemia (AA) was feasible in alternative transplantation. To identify differences in outcomes of UCBT and HLA-matched or mismatched unrelated bone marrow transplantation (UBMT) in adults with AA, we analyzed registry data of the Japan Society for Hematopoietic Cell Transplantation and compared results of UCBT (n = 69) to 8/8-matched (n = 101), 7/8-matched (n = 65), or 6/8-matched (n = 37) UBMT. The transplantation period was from 2002 to 2012, and patients 16 years or older with AA were eligible. Median ages were 49, 35, 28, and 30 years for UCBT, 8/8-matched, 7/8-matched, and 6/8-matched UBMT, respectively. In multivariate analysis, risk of mortality was lower for 8/8-matched UBMT compared with that of UCBT (hazard ratio [HR], 55; 95% confidence interval [CI], 32 to .94; P = .029), adjusted for age and graft-versus-host disease (GVHD) prophylaxis, which were other associated factors. Mortality risks of 7/8-matched UBMT (HR, 55; 95% CI, 29 to 1.02) or 6/8-matched UBMT (HR, 67; 95% CI, 32 to 1.39) were not significantly different from those of UCBT. Risks of grade 3 or 4 acute and chronic GVHD were not different among the 4 groups. The most prevalent cause of death was graft failure in UCBT and 6/8-matched UBMT and infection in 8/8-matched and 7/8-matched UBMT. Under 40 years old,survival of UCBT was similar to that of UBMT (76%, 79%, 83%, and 83% for UCBT and 8/8-matched, 7/8-matched, and 6/8-matched UBMT, respectively, at 3 years), adjusted for transplantation period, which was another associated factor; however, for ages over 40 years, that of UCBT tended to be lower (47%, 64%, 64%, and 75% for UCBT, 8/8-matched, 7/8-matched, and 6/8-matched UBMT, respectively, at 3 years). To conclude, these data suggest that UCBT could be an alternative treatment option for younger adults when matched sibling or adequate UBMT donors are not available.
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U2 - 10.1016/j.bbmt.2016.07.002
DO - 10.1016/j.bbmt.2016.07.002
M3 - Article
C2 - 27401034
AN - SCOPUS:84992049018
SN - 1083-8791
VL - 22
SP - 1836
EP - 1843
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 10
ER -