PMID- 11342417
OWN - NLM
STAT- MEDLINE
DCOM- 20010614
LR  - 20240104
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 97
IP  - 10
DP  - 2001 May 15
TI  - Survival after transplantation of unrelated donor umbilical cord blood is 
      comparable to that of human leukocyte antigen-matched unrelated donor bone 
      marrow: results of a matched-pair analysis.
PG  - 2957-61
AB  - Umbilical cord blood (UCB) is being increasingly used for hematopoietic stem cell 
      transplantation and has been associated with a reduced incidence of severe 
      graft-versus-host disease (GVHD). To further investigate the relative merits of 
      unrelated donor UCB versus bone marrow (BM), a matched-pair analysis comparing 
      the outcomes of recipients of 0 to 3 human leukocyte antigen (HLA)-mismatched UCB 
      and HLA-A, B, DRB1-matched BM was performed. UCB patients, who received 
      cyclosporine (CSA) and methylprednisolone (MP), were matched for age, diagnosis, 
      and disease stage with BM patients, who received either methotrexate (MTX) and 
      CSA (26 pairs) or T-cell depletion (TCD) and CSA/MP (31 pairs). Patients were 
      predominantly children (median age, 5 years) undergoing transplantation for 
      malignancy, storage diseases, BM failure, and immunodeficiency syndromes between 
      1991 and 1999. Although neutrophil recovery was significantly slower after UCB 
      transplantation, the probability of donor-derived engraftment at day 45 was 88% 
      in UCB versus 96% in BM-MTX recipients (P =.41) and 85% in UCB versus 90% in 
      BM-TCD recipients (P =.32), respectively. Platelet recovery was similar in UCB 
      versus BM pairs. Furthermore, incidences of acute and chronic GVHD were similar 
      in UCB and BM recipients, with 53% of UCB versus 41% of BM-MTX recipients alive 
      (P =.40) and 52% of UCB versus 56% of BM-TCD recipients alive at 2 years (P 
      >.80), respectively. These data suggest that despite increased HLA disparity, 
      probabilities of engraftment, GVHD, and survival after UCB transplantation are 
      comparable to those observed after HLA-matched BM transplantation. Therefore, UCB 
      should be considered an acceptable alternative to HLA-matched BM for pediatric 
      patients.
FAU - Barker, J N
AU  - Barker JN
AD  - Blood and Marrow Transplant Program, Department of Medicine, University of 
      Minnesota School of Medicine, Minneapolis, MN, USA. barke014@tc.umn.edu
FAU - Davies, S M
AU  - Davies SM
FAU - DeFor, T
AU  - DeFor T
FAU - Ramsay, N K
AU  - Ramsay NK
FAU - Weisdorf, D J
AU  - Weisdorf DJ
FAU - Wagner, J E
AU  - Wagner JE
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
GR  - N01-HB-67139/HB/NHLBI NIH HHS/United States
GR  - P01-CA65493/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (HLA-DRB1 Chains)
SB  - IM
MH  - Adolescent
MH  - Anemia, Aplastic/therapy
MH  - Bone Marrow Cells/immunology
MH  - *Bone Marrow Transplantation
MH  - Child
MH  - Child, Preschool
MH  - Fanconi Anemia/therapy
MH  - Fetal Blood/*cytology/immunology
MH  - Graft vs Host Disease/epidemiology
MH  - HLA-A Antigens/analysis
MH  - HLA-B Antigens/analysis
MH  - HLA-DR Antigens/analysis
MH  - HLA-DRB1 Chains
MH  - Hematologic Neoplasms/therapy
MH  - *Hematopoietic Stem Cell Transplantation
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Immunologic Deficiency Syndromes/therapy
MH  - Infant
MH  - Metabolism, Inborn Errors/therapy
MH  - Survival Rate
MH  - Transplantation Conditioning
MH  - Treatment Outcome
EDAT- 2001/05/09 10:00
MHDA- 2001/06/15 10:01
CRDT- 2001/05/09 10:00
PHST- 2001/05/09 10:00 [pubmed]
PHST- 2001/06/15 10:01 [medline]
PHST- 2001/05/09 10:00 [entrez]
AID - S0006-4971(20)55611-5 [pii]
AID - 10.1182/blood.v97.10.2957 [doi]
PST - ppublish
SO  - Blood. 2001 May 15;97(10):2957-61. doi: 10.1182/blood.v97.10.2957.