PMID- 20029048
OWN - NLM
STAT- MEDLINE
DCOM- 20100402
LR  - 20211020
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 115
IP  - 9
DP  - 2010 Mar 4
TI  - Combined effect of total nucleated cell dose and HLA match on transplantation 
      outcome in 1061 cord blood recipients with hematologic malignancies.
PG  - 1843-9
LID - 10.1182/blood-2009-07-231068 [doi]
AB  - Both total nucleated cell (TNC) dose and human leukocyte antigen (HLA)-match 
      affect the outcome of cord blood (CB) transplantation. However, how to prioritize 
      these characteristics in unit selection is not established. Therefore, we 
      analyzed the outcomes of 1061 patients who received single-unit myeloablative CB 
      transplantation for leukemia or myelodysplasia. TNC dose and HLA-match each 
      affected survival via their effect on transplant-related mortality (TRM); neither 
      was associated with relapse. Therefore, TRM was the focus of multivariate 
      analyses combining dose and HLA-match. Compared with our 1 HLA-mismatch (MM) 
      reference group with TNC 2.5 to 4.9 x 10(7)/kg, recipients of 0 MM units had the 
      lowest TRM regardless of dose (relative risk [RR] = 0.4, P = .019). TRM for 
      recipients of 1- or 2-MM units with TNC 5.0 x 10(7)/kg or greater was similar to 
      the reference group (RR = 0.8, P = .391 and RR = 1.0, P = .847) despite their 
      greater dose. Recipients of 2 MM units with TNC 2.5 to 4.9 x 10(7)/kg had a 
      greater TRM (RR = 1.5, P = .014), and those with 1 or 2 MM and TNC less than 2.5 
      x 10(7)/kg or 3 MM did substantially worse. These findings support new unit 
      selection criteria that take into account both TNC dose and HLA-match and have 
      important implications for the size of the global CB inventory needed to find an 
      optimum CB graft.
FAU - Barker, Juliet N
AU  - Barker JN
AD  - Memorial Sloan-Kettering Cancer Center, New York, NY, USA. barkerj@mskcc.org
FAU - Scaradavou, Andromachi
AU  - Scaradavou A
FAU - Stevens, Cladd E
AU  - Stevens CE
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20091222
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Blood Cell Count
MH  - Child
MH  - Child, Preschool
MH  - *Cord Blood Stem Cell Transplantation/adverse effects
MH  - Female
MH  - Fetal Blood/*cytology/*immunology
MH  - Graft Survival
MH  - Graft vs Host Disease/etiology
MH  - Hematologic Neoplasms/blood/*immunology/mortality/*therapy
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Leukocyte Count
MH  - Male
MH  - Middle Aged
MH  - Neutrophils
MH  - Platelet Count
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5003507
EDAT- 2009/12/24 06:00
MHDA- 2010/04/03 06:00
PMCR- 2010/03/04
CRDT- 2009/12/24 06:00
PHST- 2009/12/24 06:00 [entrez]
PHST- 2009/12/24 06:00 [pubmed]
PHST- 2010/04/03 06:00 [medline]
PHST- 2010/03/04 00:00 [pmc-release]
AID - S0006-4971(20)56710-4 [pii]
AID - 2009/231068 [pii]
AID - 10.1182/blood-2009-07-231068 [doi]
PST - ppublish
SO  - Blood. 2010 Mar 4;115(9):1843-9. doi: 10.1182/blood-2009-07-231068. Epub 2009 Dec 
      22.