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oai:repisalud.isciii.es:20.500.12105/229002024-11-28T19:46:58Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967col_20.500.12105_16975

00925njm 22002777a 4500 dc Sanz, Jaime author Montoro, Juan author Solano, Carlos author Valcarcel, David author Sampol Mayol, Antonia author Ferra, Christelle author Parody, Rocio author Lorenzo, Ignacio author Montesinos, Pau author Orti, Guillermo author Hernandez-Boluda, Juan-Carlos author Balaguer-Rosello, Aitana author Guerreiro, Manuel author Carretero, Carlos author Sanz, Guillermo F author Sanz, Miguel A author Pinana, Jose Luis author 2020-02 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. Sanz J, Montoro J, Solano C, Valcarcel D, Sampol A, Ferra C, et al. Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies. Biol Blood Marrow Transplant. 2020 Feb;26(2):358-66. Epub 2019 Oct 23. 10.1016/j.bbmt.2019.10.014 1523-6536 1083-8791 Biology of Blood and Marrow Transplantation http://hdl.handle.net/20.500.13003/17343 31655119 L2003958064 2-s2.0-85076518187 https://hdl.handle.net/20.500.12105/22900 507717100017 Umbilical cord blood transplantation Haploidentical transplantation Alternative donor transplantation Hematologic malignancy Allogeneic stem cell transplantation clinical trial Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies