Outcomes of transplantation of unrelated donor umbilical cord blood and bone marrow in children with acute leukaemia: a comparison study  

Oleh:

Eapen, Mary ; Rubinstein, Pablo ; Zhang, Mei-Jie ; Stevens, Cladd ; Kurtzberg, Joanne ; Scaradavou, Andromachi ; Loberiza, Fausto R. ; Champlin, Richard E. ; Klein, John P. ; Horowitz, Mary M ; Wagner, John E.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Lancet (keterangan: ada di Proquest) vol. 369 no. 9577 (Jun. 2007), page 1947.

Ketersediaan

Perpustakaan FK Nomor Panggil: L01.K.2007.03 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Summary Background Although umbilical cord blood is an accepted alternative to bone marrow for transplantation, L allele-matched bone marrow is generally regarded as the preferred graft source. Our aim was to assess leukaemia-free 5 survival after transplantations of these alternatives compared with present HLA-matching practices, and to assess 5 the relative effect of cell dose and HLA match, and their potential interaction on leukaemia-free survival after I, cord-blood transplantation. A A A Methods Outcomes of 503 children (<16 years) with acute leukaemia and transplanted with umbilical cord blood (I were compared with outcomes of282 bone-marrow recipients. All transplantation took place in the USA. Recipients J of umbilical cord blood were transplanted with grafts that were HLA-matched (n=35) or HLA-mismatched for one ~ (n=201) or two antigens (n=267) (typing at antigen level for HLA-A and HLA-B, and allele level for HLA-DRB1). ~ Bone-marrow recipients were transplanted with grafts that were matched at the allele level for HLA-A, HLA-B, u HLA-C, and HLA-DRB (n=116), or mismatched (n=166). The primary endpoint was 5-year leukaemia-free ( survival. A B p Findings In comparison with allele-matched bone-marrow transplants, 5-year leukaemia-free survival was similar to ~ that after transplants of umbilical cord blood mismatched for either one or two antigens and possibly higher after U transplants of HLA-matched umbilical cord blood. Transplant-related mortality rates were higher after transplants of U two-antigen HLA-mismatched umbilical cord blood (relative risk 2.31, p=0.0003) and possibly after one-antigen ~ HLA-mismatched low-cell.dose umbilical.cord-blood transplants (1.88, p=O. 0455). Relapse rates were lower after c two-antigen HLA-mismatched umbilical-cord-blood transplants (0.54, p=O. 0045)

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