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Mismatched Graft Effective in Adult Leukemia Treatment

Umbilical cord blood from an unrelated donor appears to be a viable transplant option

WEDNESDAY, June 16 (HealthDay News) -- Unrelated donor umbilical cord blood (UCB) appears to result in similar outcomes as allele-matched bone marrow and peripheral blood progenitor cell (PBPC) transplants for adults with leukemia, and may be a viable alternative when matches for the second two options cannot be found, according to research published online June 16 in The Lancet Oncology.

Mary Eapen, M.D., of the Medical College of Wisconsin in Milwaukee, and colleagues compared the outcomes of 165 patients who received UCB, 888 who received PBPC, and 472 who received bone marrow to ascertain the appropriateness of UCB grafts for adults with acute leukemia, and the effect of human leucocyte antigen (HLA) mismatch in all three graft sources.

At two years, the researches found that leukemia-free survival in UCB recipients was similar to that in patients who received PBPC with seven or eight matching alleles or who received bone marrow transplants, though transplant mortality itself was higher after UCB than after PBPC with eight matching alleles or bone marrow transplant (hazard ratios 1.62 and 1.69, respectively). Overall, UCB recipients experienced less acute and chronic graft-versus-host disease.

"These data support the use of UCB for adults with acute leukemia when there is no HLA-matched unrelated adult donor available, and when a transplant is needed urgently," the authors write.

One study co-author is a board member for Cord:USE and VidaCord.

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