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Cord Blood Stem Cells

Reduced-intensity hematopoietic cell transplantation in older patients with AML/MDS: umbilical cord blood is a feasible option for patients without HLA-matched sibling donors

Bone Marrow Transplantation volume 47, pages 494–498 (2012)Cite this article

Abstract

Umbilical cord blood (UCB) has increased access to hematopoietic cell transplantation (HCT) for patients without HLA-matched sibling donors (MSD). We compared outcomes of HCT using MSD (N=38) or UCB (N=60) among older patients (age ⩾55 years) with AML or myelodysplastic syndromes (MDS). All patients received a reduced intensity regimen consisting of CY, fludarabine and 200 cGy TBI. Median age at HCT was 63 years for MSD and 61 years for UCB recipients. Among UCB recipients, 95% received two UCB units and 88% received 1–2 locus HLA-mismatched units to optimize cell dose. OS at 3-years was 37% for MSD and 31% for UCB recipients (P=0.21). On multivariate analysis, donor source (MSD vs UCB) did not impact risks of OS, leukemia-free survival and relapse or treatment-related mortality. UCB is feasible as an alternative donor source for reduced-intensity conditioning HCT among older patients with AML and MDS who do not have a suitable MSD.

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Authors and Affiliations

  1. Divisions of Medical and Pediatric Hematology, Blood and Marrow Transplant Program, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA

    N S Majhail, C G Brunstein, R Shanley, K Sandhu, B McClune, B Oran, E D Warlick, J E Wagner & D J Weisdorf

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  1. N S Majhail
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  2. C G Brunstein
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  3. R Shanley
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  4. K Sandhu
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  5. B McClune
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  7. E D Warlick
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  8. J E Wagner
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  9. D J Weisdorf
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Correspondence to N S Majhail.

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Majhail, N., Brunstein, C., Shanley, R. et al. Reduced-intensity hematopoietic cell transplantation in older patients with AML/MDS: umbilical cord blood is a feasible option for patients without HLA-matched sibling donors. Bone Marrow Transplant 47, 494–498 (2012). https://doi.org/10.1038/bmt.2011.114

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