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<p>Choosing an optimal alternative donor is an important clinical concern in allogeneic hematopoietic cell transplantation (HCT). In Japan, single-unit umbilical cord blood transplantation (UCBT) has been widely used in the last two decades, whereas HCT from HLA-haploidentical related donors (haplo-HCT) has been increasingly used following the advent of posttransplant cyclophosphamide (PTCY) for graft-versus-host disease (GVHD) prophylaxis. This registry-based study aimed to compare outcomes between single-unit UCBT (<i>n </i>= 848) and PTCY-based haplo-HCT (<i>n </i>= 241) performed during first complete remission in patients with acute myeloid leukemia. UCBT was associated with a lower likelihood of engraftment (<i>P </i>&lt; 0.001), a higher risk of grade 2–4 and grade 3–4 acute GVHD (<i>P </i>= 0.003 each), and a lower risk of extensive chronic GVHD (<i>P </i>= 0.048). The UCBT and haplo-HCT groups did not significantly differ in 3-year probabilities of overall survival (68% versus 69%, <i>P </i>= 0.686), GVHD/relapse-free survival (55% versus 54%, <i>P </i>= 0.866), relapse (14% versus 16%, <i>P </i>= 0.463), and non-relapse mortality (21% versus 19%, <i>P </i>= 0.403), respectively, which were confirmed with multivariate analysis. These results indicate that both procedures should be considered viable options for patients lacking a matched donor.</p>

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Comparison of single-unit umbilical cord blood transplantation and haploidentical transplantation using posttransplant cyclophosphamide during first complete remission of acute myeloid leukemia

  • 期刊论文

  • 发表日期：

    2025年10月5日

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  • Masamitsu Yanada,
  • Satoshi Yamasaki,
  • Shohei Mizuno,
  • Junichi Sugita,
  • Takahiro Fujino,
  • Yukiko Misaki,
  • Masatsugu Tanaka,
  • Naoyuki Uchida,
  • Makoto Onizuka,
  • Noriko Doki,
  • Shuichi Ota,
  • Masashi Sawa,
  • Toshiro Kawakita,
  • Yuta Hasegawa,
  • Hirohisa Nakamae,
  • Kazuya Ishiwata,
  • Nobuhiro Hiramoto,
  • Fumihiko Ishimaru,
  • Junya Kanda,
  • Marie Ohbiki,
  • Yoshiko Atsuta,
  • Hideki Nakasone,
  • Takaaki Konuma

摘要

Choosing an optimal alternative donor is an important clinical concern in allogeneic hematopoietic cell transplantation (HCT). In Japan, single-unit umbilical cord blood transplantation (UCBT) has been widely used in the last two decades, whereas HCT from HLA-haploidentical related donors (haplo-HCT) has been increasingly used following the advent of posttransplant cyclophosphamide (PTCY) for graft-versus-host disease (GVHD) prophylaxis. This registry-based study aimed to compare outcomes between single-unit UCBT (n = 848) and PTCY-based haplo-HCT (n = 241) performed during first complete remission in patients with acute myeloid leukemia. UCBT was associated with a lower likelihood of engraftment (P < 0.001), a higher risk of grade 2–4 and grade 3–4 acute GVHD (P = 0.003 each), and a lower risk of extensive chronic GVHD (P = 0.048). The UCBT and haplo-HCT groups did not significantly differ in 3-year probabilities of overall survival (68% versus 69%, P = 0.686), GVHD/relapse-free survival (55% versus 54%, P = 0.866), relapse (14% versus 16%, P = 0.463), and non-relapse mortality (21% versus 19%, P = 0.403), respectively, which were confirmed with multivariate analysis. These results indicate that both procedures should be considered viable options for patients lacking a matched donor.