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Therapy

Effect of graft source on mismatched unrelated donor hemopoietic stem cell transplantation after reduced intensity conditioning

Leukemia volume 27, pages 2113–2117 (2013)Cite this article

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Abstract

This retrospective report compared the results of graft source on outcome after allogeneic stem cell transplantation (allo-SCT) in patients with hematologic malignancies receiving a reduced intensity conditioning (RIC) regimen. A total of 152 patients received either a RIC allo-SCT using a 9/10 mismatched unrelated donor (MisMUD, n=42) or a double unrelated umbilical cord blood (dUCB, n=110) graft. With a median follow-up of 30.3 months, the cumulative incidence of non-relapse mortality was 26% in the dUCB group versus 24% in the MisMUD group (P=0.95). Grade 3–4 acute graft-versus-host disease (GVHD) incidence was 19.7% in the dUCB group versus 21.4% in the MisMUD group (P=0.83). The cumulative incidence of extensive chronic GVHD at 2 years was 6.4% in the dUCB group versus 21.4% in the MisMUD group (P=0.02). The Kaplan–Meier estimate of overall survival at 2 years was comparable between both groups (52.3% (95% confidence interval (CI), 42.1–61.5%) in the dUCB group versus 47.9% (95% CI, 31.6–62.4%) in the MisMUD group, P=0.55). Progression-free survival at 2 years was 43.3% (95% CI, 33.7–52.5%) in the dUCB group versus 38.3% (95% CI, 23.2–53.3%) in the MisMUD group (P=0.55). These data suggest that dUCB is a valid alternative graft source with significantly less chronic GVHD compared with MisMUD in the setting of RIC allo-SCT.

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Acknowledgements

We thank the nursing staff for providing excellent care for our patients, and the following physicians for their dedicated patient care: N Blin, A Clavert, V Dubruille, T Gastinne, B Mahe, F Mechinaud and F Rialland. MM thanks Pr JV de Melo (Adelaide, Australia) for critical reading of the manuscript. FM was supported by educational grants from the ‘Association for Training, Education and Research in Hematology, Immunology and Transplantation’ (ATERHIT). We also thank the ‘Région Pays de Loire’, the ‘Association pour la Recherche sur le Cancer (ARC; grant #3175 to MM and BG)’, the ‘Fondation de France’, the ‘Fondation contre la Leucémie’, the ‘Agence de Biomédecine’, the ‘Association Cent pour Sang la Vie’, the ‘Association Laurette Fuguain’ and the IRGHET for their generous and continuous support for our clinical and basic research work. Our group is supported by several grants from the French national cancer institute (PHRC, INCa to MM). We acknowledge the continuous support of the cell banking facility (‘tumurotheque’) of the CHU de Nantes.

Author contributions

F Malard: collected, assembled and analyzed data, performed statistical analysis and wrote the manuscript; S Fürst and M Loirat: collected data and commented on the manuscript; P Chevallier, T Guillaume, J Delaunay, Jean El-Cheikh, S. Le Gouill, P Moreau and Didier Blaise: recruited patients and commented on the manuscript; M Mohty: recruited patients, supervised research, analyzed data and wrote the manuscript; all authors approved submission of the manuscript for publication purposes.

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Authors and Affiliations

  1. Centre Hospitalier et Universitaire (CHU) de Nantes, Service d'Hématologie Clinique, Nantes, France

    F Malard, M Loirat, P Chevallier, T Guillaume, J Delaunay, S Le Gouill, P Moreau & M Mohty

  2. INSERM CRNCA UMR 892, Université de Nantes, Faculté de Médecine, Nantes, France

    F Malard, S Le Gouill, P Moreau & M Mohty

  3. Unité de Transplantation et de Thérapie Cellulaire (U2T), Institut Paoli-Calmettes, Marseille, France

    S Fürst, J El-Cheikh & D Blaise

  4. Centre d'Investigation Clinique en Cancérologie (CI2C), CHU de Nantes, Nantes, France

    S Le Gouill, P Moreau & M Mohty

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  1. F Malard
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Correspondence to M Mohty.

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Malard, F., Fürst, S., Loirat, M. et al. Effect of graft source on mismatched unrelated donor hemopoietic stem cell transplantation after reduced intensity conditioning. Leukemia 27, 2113–2117 (2013). https://doi.org/10.1038/leu.2013.170

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