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Blood, 19 February 2009, Vol. 113, No. 8, pp. 1631-1638. Prepublished online as a Blood First Edition Paper on December 22, 2008; DOI 10.1182/blood-2008-03-147041. This Article Full Text Full Text (PDF) Supplemental Appendix and Figure All Versions of this Article: blood-2008-03-147041v1 113/8/1631    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Atsuta, Y. Articles by Kato, S. Search for Related Content PubMed PubMed Citation Articles by Atsuta, Y. Articles by Kato, S. Related Collections Transplantation Free Research Articles Myeloid Neoplasia Lymphoid Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Disease-specific analyses of unrelated cord blood transplantation compared with unrelated bone marrow transplantation in adult patients with acute leukemia Yoshiko Atsuta1, Ritsuro Suzuki1, Tokiko Nagamura-Inoue2, Shuichi Taniguchi3, Satoshi Takahashi4, Shunro Kai5, Hisashi Sakamaki6, Yasushi Kouzai7, Masaharu Kasai8, Takahiro Fukuda9, Hiroshi Azuma10, Minoko Takanashi11, Shinichiro Okamoto12, Masahiro Tsuchida13, Keisei Kawa14, Yasuo Morishima15, Yoshihisa Kodera16, Shunichi Kato17, and for the Japan Marrow Donor Program and the Japan Cord Blood Bank Network 1 Department of Hematopoietic Stem Cell Transplantation Data Management, Nagoya University School of Medicine, Nagoya; 2 Department of Cell Processing & Transfusion, Research Hospital, Institute of Medical Science, University of Tokyo, and Tokyo Cord Blood Bank, Tokyo; 3 Department of Hematology, Toranomon Hospital, Tokyo; 4 Department of Molecular Therapy, Institute of Medical Science, University of Tokyo, Tokyo; 5 Department of Transfusion Medicine, Hyogo College of Medicine, Nishinomiya; 6 Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo; 7 Department of Transfusion Medicine, Tokyo Metropolitan Fuchu Hospital, Tokyo; 8 Department of Hematology, Sapporo Hokuyu Hospital, Sapporo; 9 Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, Tokyo; 10 Hokkaido Red Cross Blood Center, Sapporo; 11 Japanese Red Cross Tokyo Blood Center, Tokyo; 12 Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo; 13 Ibaraki Children's Hospital, Mito; 14 Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi; 15 Aichi Cancer Center Hospital, Nagoya; 16 BMT Center, Japanese Red Cross Nagoya First Hospital, Nagoya; and 17 Department of Cell Transplantation & Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan We made a disease-specific comparison of unrelated cord blood (CB) recipients and human leukocyte antigen allele–matched unrelated bone marrow (BM) recipients among 484 patients with acute myeloid leukemia (AML; 173 CB and 311 BM) and 336 patients with acute lymphoblastic leukemia (ALL; 114 CB and 222 BM) who received myeloablative transplantations. In multivariate analyses, among AML cases, lower overall survival (hazard ratio [HR] = 1.5; 95% confidence interval [CI], 1.0-2.0, P = .028) and leukemia-free survival (HR = 1.5; 95% CI, 1.1-2.0, P = .012) were observed in CB recipients. The relapse rate did not differ between the 2 groups of AML (HR = 1.2; 95% CI, 0.8-1.9, P = .38); however, the treatment-related mortality rate showed higher trend in CB recipients (HR = 1.5; 95% CI, 1.0-2.3, P = .085). In ALL, there was no significant difference between the groups for relapse (HR = 1.4, 95% CI, 0.8-2.4, P = .19) and treatment-related mortality (HR = 1.0; 95% CI, 0.6-1.7, P = .98), which contributed to similar overall survival (HR = 1.1; 95% CI, 0.7-1.6, P = .78) and leukemia-free survival (HR = 1.2; 95% CI, 0.9-1.8, P = .28). Matched or mismatched single-unit CB is a favorable alternative stem cell source for patients without a human leukocyte antigen–matched related or unrelated donor. For patients with AML, decreasing mortality, especially in the early phase of transplantation, is required to improve the outcome for CB recipients. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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