Sanz, JaimeMontoro, JuanSolano, CarlosValcarcel, DavidSampol Mayol, AntoniaFerra, ChristelleParody, RocioLorenzo, IgnacioMontesinos, PauOrti, GuillermoHernandez-Boluda, Juan-CarlosBalaguer-Rosello, AitanaGuerreiro, ManuelCarretero, CarlosSanz, Guillermo FSanz, Miguel APinana, Jose Luis2024-09-132024-09-132020-02Sanz 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 23.1083-8791http://hdl.handle.net/20.500.13003/17343https://hdl.handle.net/20.500.12105/22900In 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.enghttp://creativecommons.org/licenses/by-nc-nd/4.0/Umbilical cord blood transplantationHaploidentical transplantationAlternative donor transplantationHematologic malignancyAllogeneic stem cell transplantation clinical trialresearch articleAttribution-NonCommercial-NoDerivatives 4.0 International31655119262358-36610.1016/j.bbmt.2019.10.0141523-6536Biology of Blood and Marrow Transplantationopen access2-s2.0-85076518187507717100017L2003958064