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Cord Blood Transplants Beneficial When Matched Donors Cannot Be Found

September 14, 2016

Stem cell research, conceptual artwork

The majority of patients in need of allogeneic hematopoietic cell-transplants do not have HLA-matched donors available. Researchers recently performed a retrospective study including 582 patients with acute myeloid or lymphoid leukemia or myelodysplastic syndrome in need of hematopoietic cell-transplants. HLA-matched unrelated donors were found for 344 patients; 98 patients received a transplant from an HLA-mismatched donor; and 140 patients received a cord-blood transplant.   Compared to patients with residual disease who received cord-blood transplants, patients with residual disease who had a matched transplant (adjusted hazard ratio, 1.69; 95% CI, 0.94 to 3.02; P=0.08) or mismatched transplant (adjusted hazard ratio, 2.92; 95% CI, 1.52 to 5.63; P=0.001) had a higher risk of death. Among patients with residual disease, cord-blood transplant recipients also had lower rates of relapse than patients receiving either matched or mismatched transplants.  Similar trends were observed for patients without minimal residual disease.  In conclusion, cord-blood transplants are beneficial for patients in need of allogeneic hematopoietic cell transplants, especially when HLA-matched donors cannot be found.

Reference:

 

  1. Milano F, Gooley T, Wood B, Woolfrey A, Flowers ME, Doney K, Witherspoon R, Mielcarek M, Deeg JH, Sorror M, Dahlberg A, Sandmaier BM, Salit R, Petersdorf E, Appelbaum FR, Delaney C. Cord-Blood Transplantation in Patients with Minimal Residual Disease. N Engl J Med 2016;375: 944-53.

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