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Blood, 1 December 2004, Vol. 104, No. 12, pp. 3813-3820.
Prepublished online as a Blood First Edition Paper on July 27, 2004; DOI 10.1182/blood-2004-03-1001.
 Previous Article | Next Article 
Submitted March 17, 2004
Accepted July 10, 2004
Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematological malignancies
Satoshi Takahashi*, Tohru Iseki, Jun Ooi, Akira Tomonari, Kashiya Takasugi, Yoko Shimohakamada, Toshiki Yamada, Kaoru Uchimaru, Arinobu Tojo, Naoki Shirafuji, Hideki Kodo, Kenzaburo Tani, Tsuneo Takahashi, Takuhiro Yamaguchi, and Shigetaka Asano
Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Division of Cell Processing, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Department of Biostatistics/Epidemiology and Preventive Health Sciences, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan
* Corresponding author; email: radius{at}ims.u-tokyo.ac.jp.
Unrelated cord blood transplantation (CBT) has now become more common, but as yet there have been only a few reports on its outcome compared with bone marrow transplantation (BMT), especially for adults. We studied the clinical outcomes of 113 adult patients with hematological malignancies who received unrelated BMT (n=45) or unrelated CBT (n=68). We analyzed the hematopoietic recovery, rates of graft-versus-host disease (GVHD), risks of transplant-related mortality (TRM) and relapse, and disease-free survival (DFS) using stepwise Cox analyses. The time from donor-search to transplantation was significantly shorter among CBT recipients (median 2 months) than BMT recipients (median 11 months; P<0.01). Multivariate analysis demonstrated slow neutrophil (P<0.01) and platelet (P<0.01) recoveries in CBT compared with BMT. Despite rapid tapering of immunosuppressants post-transplant and infrequent use of steroids to treat severe acute GVHD, there were no GVHD-related deaths among CBT recipients, compared with 10 deaths out of 24 among BMT recipients. Unrelated CBT showed better TRM and DFS results compared with BMT (P=0.02 and P<0.01, respectively) despite the higher human leukocyte antigen mismatching rate and lower number of infused cells. These data strongly suggest that CBT could be safely and effectively used for adult patients with hematological malignancies.
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