Reduced intensity haplo plus single cord transplant compared to double cord transplant: improved engraftment and graft-versus-host disease-free, relapse-free survival
Koen van Besien,
Parameswaran Hari,
Mei-Jie Zhang,
Hong-Tao Liu,
Wendy Stock,
Lucy Godley,
Olatoyosi Odenike,
Richard Larson,
Michael Bishop,
Amittha Wickrema,
Usama Gergis,
Sebastian Mayer,
Tsiporah Shore,
Stephanie Tsai,
Joanna Rhodes,
Melissa M. Cushing,
Sandra Korman,
Andrew Artz
Affiliations
Koen van Besien
Department of Hematology/Oncology and Meyer Cancer Center – Stem Cell Transplant Program, Weill Cornell Medical College, New York, NY, USA
Parameswaran Hari
Center for International Bone Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA
Mei-Jie Zhang
Center for International Bone Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA
Hong-Tao Liu
Section of Hematology/Oncology-Hematopoietic Cellular Therapy Program, University of Chicago, Il, USA
Wendy Stock
Section of Hematology/Oncology-Hematopoietic Cellular Therapy Program, University of Chicago, Il, USA
Lucy Godley
Section of Hematology/Oncology-Hematopoietic Cellular Therapy Program, University of Chicago, Il, USA
Olatoyosi Odenike
Section of Hematology/Oncology-Hematopoietic Cellular Therapy Program, University of Chicago, Il, USA
Richard Larson
Section of Hematology/Oncology-Hematopoietic Cellular Therapy Program, University of Chicago, Il, USA
Michael Bishop
Section of Hematology/Oncology-Hematopoietic Cellular Therapy Program, University of Chicago, Il, USA
Amittha Wickrema
Section of Hematology/Oncology-Hematopoietic Cellular Therapy Program, University of Chicago, Il, USA
Usama Gergis
Department of Hematology/Oncology and Meyer Cancer Center – Stem Cell Transplant Program, Weill Cornell Medical College, New York, NY, USA
Sebastian Mayer
Department of Hematology/Oncology and Meyer Cancer Center – Stem Cell Transplant Program, Weill Cornell Medical College, New York, NY, USA
Tsiporah Shore
Department of Hematology/Oncology and Meyer Cancer Center – Stem Cell Transplant Program, Weill Cornell Medical College, New York, NY, USA
Stephanie Tsai
Department of Hematology/Oncology and Meyer Cancer Center – Stem Cell Transplant Program, Weill Cornell Medical College, New York, NY, USA
Joanna Rhodes
Department of Hematology/Oncology and Meyer Cancer Center – Stem Cell Transplant Program, Weill Cornell Medical College, New York, NY, USA
Melissa M. Cushing
Department of Pathology – Cellular Therapy Laboratory, Weill Cornell Medical College, New York, NY, USA
Sandra Korman
Center for International Bone Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA
Andrew Artz
Department of Hematology/Oncology and Meyer Cancer Center – Stem Cell Transplant Program, Weill Cornell Medical College, New York, NY, USA
Umbilical cord blood stem cell transplants are commonly used in adults lacking HLA-identical donors. Delays in hematopoietic recovery contribute to mortality and morbidity. To hasten recovery, we used co-infusion of progenitor cells from a partially matched related donor and from an umbilical cord blood graft (haplo-cord transplant). Here we compared the outcomes of haplo-cord and double-cord transplants. A total of 97 adults underwent reduced intensity conditioning followed by haplo-cord transplant and 193 patients received reduced intensity conditioning followed by double umbilical cord blood transplantation. Patients in the haplo-cord group were more often from minority groups and had more advanced malignancy. Haplo-cord recipients received fludarabine-melphalan-anti-thymocyte globulin. Double umbilical cord blood recipients received fludarabine-cyclophosphamide and low-dose total body irradiation. In a multivariate analysis, haplo-cord had faster neutrophil (HR=1.42, P=0.007) and platelet (HR=2.54, P
