Outcomes of Haplo-Cord Versus Dual Cord Transplants: A Single-Center Retrospective Analysis.

Autor: Kent A; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Gil KB; Department of Internal Medicine, The University of Colorado School of Medicine, Aurora, Colorado., Jones MK; Department of Internal Medicine, The University of Colorado School of Medicine, Aurora, Colorado., Linden B; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Purev E; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Haverkos B; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Schwartz M; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., McMahon C; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Amaya M; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Smith CA; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Bosma G; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Abbott D; Department of Biostatistics and Informatics, The University of Colorado, Center for Innovative Design and Analysis, Aurora, Colorado., Rabinovitch R; Department of Radiation Oncology, The University of Colorado School of Medicine, Aurora, Colorado., Milgrom SA; Department of Radiation Oncology, The University of Colorado School of Medicine, Aurora, Colorado., Pollyea DA; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado., Gutman JA; The University of Colorado School of Medicine, Division of Hematology, Aurora, Colorado. Electronic address: jonathan.gutman@cuanschutz.edu.
Jazyk: angličtina
Zdroj: Transplantation and cellular therapy [Transplant Cell Ther] 2024 Aug 17. Date of Electronic Publication: 2024 Aug 17.
DOI: 10.1016/j.jtct.2024.07.021
Abstrakt: Despite the concurrent use of haploidentical cord (HCT) and dual cord (DCT) stem cell transplant approaches for over a decade, there have been few comparisons of their outcomes. Our objective in this study is to assess for differences in the outcomes and adverse effects associated with HCTs versus DCTs. Here we report a retrospective analysis of HCTs and DCTs at our institution. From October 2012 to October 2022, 70 HCT and 133 DCT transplants were performed following 50 mg/kg of IV cyclophosphamide, 150 mg/m 2 of IV fludarabine, 10 mg/kg of IV thiotepa, and 4 Gy total body irradiation conditioning. With a median follow-up of 3.6 years among survivors, there was no difference in overall survival (OS) (3 years OS 65% DCT versus 63% HCT, P = 1) or relapse-free survival (3 years RFS 62% DCT versus 64% HCT, P = .97) for all patients. Time to neutrophil recovery was faster in HCT recipients (median 17 versus 22 days, P = .021), with no difference in platelet recovery to 20,000/μL (P = .12). Median hospitalization for HCT recipients was 20 days versus 24 days for DCT recipients (P < .0001). Engraftment syndrome treated with steroids occurred in 47/133 (35%) DCT recipients versus 42/70 (60%) HCT recipients (odds ratios 0.37, P value=.001). There was a significant increase in grade 3 to 4 acute graft-versus-host disease (aGVHD) in haplo-cord recipients (P = .007), but no difference in grade 2 to 4 aGVHD (P = .11), all chronic GVHD (cGVHD) (P = .9), or moderate-severe cGVHD (P = .3). Our outcomes demonstrate faster engraftment and shorter hospitalization in HCTs relative to DCTs, but more engraftment syndrome and higher grade 3 to 4 aGVHD. When both are options, these factors should guide the choice between HCTs and DCTs.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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