Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies

In this prospective randomized study, we compared the outcomes of single-unit umbilical cord blood transplantation (UCBT) and unmanipulated haploidentical stem cell transplantation (haplo-SCT) with post-transplantation cyclophosphamide (PTCy) in adults with hematologic malignancies. All patients rec...

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Autores: Sanz, J, Montoro, J, Solano, C, Valcarcel, D, Sampol, A, Ferra, C, Parody, R, Lorenzo, I, Montesinos, P, Orti, G, Hernandez-Boluda, JC, Balaguer-Rosello, A, Guerreiro, M, Carretero, C, Sanz, GF, Sanz, MA, Pinana, JL
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p4381
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/4381
Access Level:acceso abierto
Palabra clave:Umbilical cord blood transplantation
Haploidentical transplantation
Alternative donor transplantation
Hematologic malignancy
Allogeneic stem cell transplantation clinical trial
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spelling Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic MalignanciesSanz, JMontoro, JSolano, CValcarcel, DSampol, AFerra, CParody, RLorenzo, IMontesinos, POrti, GHernandez-Boluda, JCBalaguer-Rosello, AGuerreiro, MCarretero, CSanz, GFSanz, MAPinana, JLUmbilical cord blood transplantationHaploidentical transplantationAlternative donor transplantationHematologic malignancyAllogeneic stem cell transplantation clinical trialIn this prospective randomized study, we compared the outcomes of single-unit umbilical cord blood transplantation (UCBT) and unmanipulated haploidentical stem cell transplantation (haplo-SCT) with post-transplantation cyclophosphamide (PTCy) in adults with hematologic malignancies. All patients received a myeloablative conditioning (MAC) regimen consisting of thiotepa, busulfan, and fludarabine, with antithymocyte globulin (ATG) added for UCBT recipients. Nineteen patients were randomized to UCBT and the other 26 to haplo-HSCT. Four patients (15%) allocated to the haplo-HSCT arm lacked a suitable donor and were crossed over to the UCBT arm. Finally, 23 underwent UCBT and 22 underwent haplo-HSCT. The cumulative incidence of neutrophil recovery was 87% at a median of 19 days (range, 13 to 24 days) in the UCBT arm versus 100% at a median of 17 days (range, 13 to 25 days) in the haplo-SCT arm (P=.04). Platelet recovery was 70% at a median of 40 days (range, 18 to 129 days) in the UCBT arm versus 86% at a median of 24 days (range, 12 to 127 days) in the haplo-HCT arm (P=.02). Rates of acute graft-versus-host disease (GVHD) grade II-IV or grade overall chronic GVHD, and extensive chronic GVHD in the UCBT and Haplo-SCT arms were 43% versus 36% (P=.8), 9% versus 9% (P=1), 66% versus 43% (P=.04), and 41% versus 23% (P=.2), respectively. Two-year nonrelapse mortality and relapse in the 2 arms were 52% versus 23% (P=.06) and 17% versus 23% (P=.5), respectively. Two-year disease-free survival, overall survival, and GVHD/relapse-free survival in the 2 arms were 30% versus 54% (P=.2), 35% versus 59% (P=.1), and 17% versus 40% (P=.04), respectively. Our data show that in the context of an MAC regimen, haplo-SCT with PTCy provides improved outcomes compared with ATG-containing single-unit UCBT. (C) 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.ELSEVIER SCIENCE INC2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/4381BIOLOGY OF BLOOD AND MARROW TRANSPLANTATIONISSN: 10838791ISSNe: 15236536reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p43812026-06-07T16:35:31Z
dc.title.none.fl_str_mv Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies
title Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies
spellingShingle Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies
Sanz, J
Umbilical cord blood transplantation
Haploidentical transplantation
Alternative donor transplantation
Hematologic malignancy
Allogeneic stem cell transplantation clinical trial
title_short Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies
title_full Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies
title_fullStr Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies
title_full_unstemmed Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies
title_sort Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies
dc.creator.none.fl_str_mv Sanz, J
Montoro, J
Solano, C
Valcarcel, D
Sampol, A
Ferra, C
Parody, R
Lorenzo, I
Montesinos, P
Orti, G
Hernandez-Boluda, JC
Balaguer-Rosello, A
Guerreiro, M
Carretero, C
Sanz, GF
Sanz, MA
Pinana, JL
author Sanz, J
author_facet Sanz, J
Montoro, J
Solano, C
Valcarcel, D
Sampol, A
Ferra, C
Parody, R
Lorenzo, I
Montesinos, P
Orti, G
Hernandez-Boluda, JC
Balaguer-Rosello, A
Guerreiro, M
Carretero, C
Sanz, GF
Sanz, MA
Pinana, JL
author_role author
author2 Montoro, J
Solano, C
Valcarcel, D
Sampol, A
Ferra, C
Parody, R
Lorenzo, I
Montesinos, P
Orti, G
Hernandez-Boluda, JC
Balaguer-Rosello, A
Guerreiro, M
Carretero, C
Sanz, GF
Sanz, MA
Pinana, JL
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Umbilical cord blood transplantation
Haploidentical transplantation
Alternative donor transplantation
Hematologic malignancy
Allogeneic stem cell transplantation clinical trial
topic Umbilical cord blood transplantation
Haploidentical transplantation
Alternative donor transplantation
Hematologic malignancy
Allogeneic stem cell transplantation clinical trial
description In this prospective randomized study, we compared the outcomes of single-unit umbilical cord blood transplantation (UCBT) and unmanipulated haploidentical stem cell transplantation (haplo-SCT) with post-transplantation cyclophosphamide (PTCy) in adults with hematologic malignancies. All patients received a myeloablative conditioning (MAC) regimen consisting of thiotepa, busulfan, and fludarabine, with antithymocyte globulin (ATG) added for UCBT recipients. Nineteen patients were randomized to UCBT and the other 26 to haplo-HSCT. Four patients (15%) allocated to the haplo-HSCT arm lacked a suitable donor and were crossed over to the UCBT arm. Finally, 23 underwent UCBT and 22 underwent haplo-HSCT. The cumulative incidence of neutrophil recovery was 87% at a median of 19 days (range, 13 to 24 days) in the UCBT arm versus 100% at a median of 17 days (range, 13 to 25 days) in the haplo-SCT arm (P=.04). Platelet recovery was 70% at a median of 40 days (range, 18 to 129 days) in the UCBT arm versus 86% at a median of 24 days (range, 12 to 127 days) in the haplo-HCT arm (P=.02). Rates of acute graft-versus-host disease (GVHD) grade II-IV or grade overall chronic GVHD, and extensive chronic GVHD in the UCBT and Haplo-SCT arms were 43% versus 36% (P=.8), 9% versus 9% (P=1), 66% versus 43% (P=.04), and 41% versus 23% (P=.2), respectively. Two-year nonrelapse mortality and relapse in the 2 arms were 52% versus 23% (P=.06) and 17% versus 23% (P=.5), respectively. Two-year disease-free survival, overall survival, and GVHD/relapse-free survival in the 2 arms were 30% versus 54% (P=.2), 35% versus 59% (P=.1), and 17% versus 40% (P=.04), respectively. Our data show that in the context of an MAC regimen, haplo-SCT with PTCy provides improved outcomes compared with ATG-containing single-unit UCBT. (C) 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/4381
url https://incliva.portalinvestigacion.com/publicaciones/4381
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
ISSN: 10838791
ISSNe: 15236536
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
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repository.mail.fl_str_mv
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