Reduced-intensity hematopoietic cell transplantation in older patients with AML/MDS: Umbilical cord blood is a feasible option for patients without HLA-matched sibling donors

N. S. Majhail, C. G. Brunstein, R. Shanley, K. Sandhu, B. McClune, B. Oran, E. D. Warlick, J. E. Wagner, D. J. Weisdorf

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Umbilical cord blood (UCB) has increased access to hematopoietic cell transplantation (HCT) for patients without HLA-matched sibling donors (MSD). We compared outcomes of HCT using MSD (N=38) or UCB (N=60) among older patients (age ≥55 years) with AML or myelodysplastic syndromes (MDS). All patients received a reduced intensity regimen consisting of CY, fludarabine and 200 cGy TBI. Median age at HCT was 63 years for MSD and 61 years for UCB recipients. Among UCB recipients, 95% received two UCB units and 88% received 1-2 locus HLA-mismatched units to optimize cell dose. OS at 3-years was 37% for MSD and 31% for UCB recipients (P=0.21). On multivariate analysis, donor source (MSD vs UCB) did not impact risks of OS, leukemia-free survival and relapse or treatment-related mortality. UCB is feasible as an alternative donor source for reduced-intensity conditioning HCT among older patients with AML and MDS who do not have a suitable MSD.

Original languageEnglish (US)
Pages (from-to)494-498
Number of pages5
JournalBone marrow transplantation
Volume47
Issue number4
DOIs
StatePublished - Apr 1 2012

Keywords

  • AML
  • hematopoietic cell transplantation
  • myelodysplastic syndromes
  • older patients
  • reduced-intensity conditioning
  • umbilical cord blood

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