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Blood, 12 March 2009, Vol. 113, No. 11, pp. 2410-2415. Prepublished online as a Blood First Edition Paper on November 7, 2008; DOI 10.1182/blood-2008-07-163238. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-07-163238v1 113/11/2410    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 HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by MacMillan, M. L. Articles by Wagner, J. E. Search for Related Content PubMed PubMed Citation Articles by MacMillan, M. L. Articles by Wagner, J. E. Related Collections Transplantation Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Acute graft-versus-host disease after unrelated donor umbilical cord blood transplantation: analysis of risk factors Margaret L. MacMillan1,2, Daniel J. Weisdorf1,3, Claudio G. Brunstein1,3, Qing Cao1,2, Todd E. DeFor1,2, Michael R. Verneris1,2, Bruce R. Blazar1,2, and John E. Wagner1,2 1 Blood and Marrow Transplant Program and Departments of 2 Pediatrics and 3 Medicine, University of Minnesota Medical School, Minneapolis Acute graft-versus-host disease (GVHD) occurs less frequently after umbilical cord blood transplantation (UCBT). More recent investigations include the use of 2 partially human leukocyte antigen (HLA)–matched UCB units, or double UCB graft, to meet the minimum cell-dose requirement. The purpose of this analysis was to assess the relative risk of acute GVHD in 265 consecutive patients receiving transplants with UCB graft composed of 1 (n = 80) or 2 (n = 185) units. The incidence of grade III-IV acute GVHD was similar between cohorts. However, the incidence of grade II-IV acute GVHD was higher among double UCBT recipients (58 vs 39%, P < .01). Three risk factors for grade II-IV acute GVHD were identified in multiple regression analysis: use of 2 UCB units, use of nonmyeloablative conditioning, and absence of antithymocyte globulin in the conditioning regimen. Transplantation-related mortality (TRM) at 1 year, however, was significantly lower after double UCBT (24 vs 39%, P = .02) even if recipients had grade II-IV acute GVHD (20 vs 39%, P = .05). These data suggest that, despite a higher incidence of grade II acute GVHD in recipients of 2 partially HLA-matched UCB units, there is no adverse effect on TRM. This study is registered at http://www.clinicaltrials.gov under the identifiers NCT00305682 [ClinicalTrials.gov] and NCT00309842 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Delaney Are 2 cords better than 1? Blood, November 5, 2009; 114(19): 3980 - 3981. [Full Text] [PDF] M. R. Verneris, C. G. Brunstein, J. Barker, M. L. MacMillan, T. DeFor, D. H. McKenna, M. J. Burke, B. R. Blazar, J. S. Miller, P. B. McGlave, et al. Relapse risk after umbilical cord blood transplantation: enhanced graft-versus-leukemia effect in recipients of 2 units Blood, November 5, 2009; 114(19): 4293 - 4299. [Abstract] [Full Text] [PDF]

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