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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 (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 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted March 25, 2008 Accepted November 14, 2008 Disease-specific analyses of unrelated cord blood transplant compared with unrelated bone marrow transplant in adult patients with acute leukemia Yoshiko Atsuta*, Ritsuro Suzuki, Tokiko Nagamura-Inoue, Shuichi Taniguchi, Satoshi Takahashi, Shunro Kai, Hisashi Sakamaki, Yasushi Kouzai, Masaharu Kasai, Takahiro Fukuda, Hiroshi Azuma, Minoko Takanashi, Shinichiro Okamoto, Masahiro Tsuchida, Keisei Kawa, Yasuo Morishima, Yoshihisa Kodera, and Shunichi Kato Department of HSCT Data Management, Nagoya University School of Medicine, Nagoya, Japan Department of Cell Processing & Transfusion, Research Hospital, The Institute of Medical Science, The University of Tokyo, and Tokyo Cord Blood Bank, Tokyo, Japan Department of Hematology, Toranomon Hospital, Tokyo, Japan Department of Molecular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan Department of Transfusion Medicine, Hyogo College of Medicine, Nishinomiya, Japan Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan Department of Transfusion Medicine, Tokyo Metropolitan Fuchu Hospital, Tokyo, Japan Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, Tokyo, Japan Hokkaido Red Cross Blood Center, Sapporo, Japan The Japanese Red Cross Tokyo Blood Center, Tokyo, Japan Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan Ibaraki Children's Hospital, Mito, Japan Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan Aichi Cancer Center Hospital, Nagoya, Japan BMT Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan Department of Cell Transplantation & Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan * Corresponding author; email: y-atsuta{at}med.nagoya-u.ac.jp. We made a disease-specific comparison of the outcomes 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) (CB/BM = 173/311) and 336 patients with acute lymphoblastic leukemia (ALL) (CB/BM = 114/222) who received myeloablative transplants between 2000 and 2005. In multivariate analyses, among AML cases, lower overall survival ((hazard ratio [HR]=1.5, 95% confidence interval [CI], 1.0-2.0, p=0.028) and leukemia-free survival (HR=1.5, 95%CI, 1.1-2.0, p=0.012) were observed in CB recipients. The relapse rate did not differ between the two groups of AML (HR=1.2, 95%CI, 0.8-1.9, p=0.38); however, the treatment-related mortality (TRM) rate showed higher trend in CB recipients (HR=1.5, 95% CI, 1.0-2.3, p=0.085). In ALL, there was no significant difference between the groups for relapse (HR=1.4, 95%CI, 0.8-2.4, p=0.19) and TRM (HR=1.0, 95%CI, 0.6-1.7, p=0.98), which contributed to similar overall survival (HR=1.1, 95%CI, 0.7-1.6, p=0.78) and leukemia-free survival (HR=1.2, 95%CI, 0.9-1.8, p=0.28). Matched or mismatched single unit cord blood is a favorable alternative stem cell source for patients without an HLA-matched related or unrelated donor. For patients with AML, decreasing mortality especially in the early phase of transplant is required to improve the outcome for CB recipients. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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