Impact of donor types on reduced-intensity conditioning allogeneic stem cell transplant for mature lymphoid malignancies

Nobuhiko Imahashi, Seitaro Terakura, Eisei Kondo, Koji Kato, Sung Won Kim, Akihito Shinohara, Mizuki Watanabe, Takahiro Fukuda, Naoyuki Uchida, Hikaru Kobayashi, Jun Ishikawa, Keisuke Kataoka, Souichi Shiratori, Takashi Ikeda, Ken ichi Matsuoka, Shuro Yoshida, Tadakazu Kondo, Takafumi Kimura, Makoto Onizuka, Tatsuo IchinoheYoshiko Atsuta, Junya Kanda

Research output: Contribution to journalArticlepeer-review

Abstract

We retrospectively compared the outcomes of reduced-intensity conditioning (RIC) transplantation from matched related donors (MRD; n = 266), matched unrelated donors (MUD; n = 277), and umbilical cord blood (UCB; n = 513) for mature lymphoid malignancies. The 3-year overall survival rates for the MRD, MUD, and UCB groups were 54%, 59%, and 40%, respectively (P < 0.001). Multivariate analysis showed no differences in survival between the MRD group and the MUD or UCB group. However, survival was significantly affected by the conditioning regimen and graft-versus-host disease (GVHD) prophylaxis in the UCB group, but not in the MRD and MUD groups. Notably, multivariate analysis showed that the risk of overall mortality in the UCB recipients who received the optimal conditioning regimen and GVHD prophylaxis (n = 116) was lower than that in the MRD group (relative risk [RR], 0.69; P = 0.03) and tended to be lower than that in the MUD group (RR, 0.75; P = 0.09). Our results suggest that UCB transplantation performed with the optimal conditioning regimen and GVHD prophylaxis is highly effective. Moreover, UCB is readily available. Thus, UCB transplantation with the optimal conditioning regimen and GVHD prophylaxis is preferable to MUD transplantation when MRD are not available in the setting of RIC transplantation for mature lymphoid malignancies.

Original languageEnglish
JournalBone Marrow Transplantation
DOIs
Publication statusAccepted/In press - 2021
Externally publishedYes

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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