Table 3.

Engraftment, GVHD, and survival in series comparing UCBT with BMT

Reference no.
Age, y (median)
Donor-recipient HLA mismatch
Myeloid engraftment, % (median, d)
Platelet engraftment at day 180, % (median, d)
Acute GVHD grade II-IV, % (III-IV) [chronic GVHD]
Survival, %
Comments
Ref no. 133         
    Type of HCT and patient nos.     At day 60     3-year overall survival   
        UCBT: 113   < 1-15 (5)   HLA-identical sibling   89 (26)   86 (44)*   14 (2) [5]   64   Comparison of UCBT and BMT from HLA-identical sibling donors.  
        BMT: 2052   < 1-15 (8)   HLA-identical sibling   98 (18)   96 (24)*   24 (10) [14]   66  

  1. There was a significantly longer time to platelet recovery in the early transplantation period (< 35 days) with UCBT

  2. Risk of acute and chronic GVHD was significantly lower with UCBT

  3. No significant difference in 100-day or 3-year survival observed between UCBT or BMT groups for either malignant or nonmalignant diseases

 
Ref no. 31         
    Type of HCT and patient nos.    % with mismatched grafts   At day 60     2-year DFS (relapse rate)   
        UBMT: 262   5-12 (8)   18%: 1 HLA-mm   96 (18)   85 (29)*   56 (29) [46]   43 (39)  

  1. Significant delay of neutrophil and platelet engraftment in UCBT group

  2. Neutrophil and platelet recovery correlated with nucleated cell dose (< 3.7 vs > 3.7 × 107 cells/kg) but not with HLA-disparity for UCBT

  3. Decreased acute GVHD in the UCBT and T-UBMT groups compared with UBMT group

 
        T-UBMT: 180   6-12 (8)   40%: 1-2 HLA-mm   90 (16)   85 (29)*   19 (8) [12]   37 (47)   
        UCBT: 99   2.5-10 (6)   89%: 1-3 HLA-mm   80 (32)   90 (81)*   33 (21) [25]   31 (38)   
Ref no. 34         
    Comparison groups (patient numbers)    HLA-6/6 match   At day 45     2-year overall survival   
        UCB vs BM-MTX (n = 26 each)   (4.5) vs (4.7)   19% vs 100%   88 (29) vs 96 (22)   72 (66) vs 76 (30)†   42 (19) vs 35 (8)   53 vs 41   Matched-pair analysis.  
        UCB vs BM-TCD (n = 31 each)
 		 (5.8) vs (6.8)
 		 13% vs 100%
 		 85 (27) vs 90 (14)
 		 84 (61) vs 84 (59)†
 		 36 (10) vs 35 (13)
 		 52 vs 56
 

  1. No difference in graft failure among comparison groups.

  2. Neutrophil recovery was significantly delayed in UCBT group vs BM-MTX or BM-TCD.

  3. No difference in acute/chronic GVHD in comparison groups

  4. Survival at 100 days/2 years was comparable between BM and UCB pairs

 
Reference no.
Age, y (median)
Donor-recipient HLA mismatch
Myeloid engraftment, % (median, d)
Platelet engraftment at day 180, % (median, d)
Acute GVHD grade II-IV, % (III-IV) [chronic GVHD]
Survival, %
Comments
Ref no. 133         
    Type of HCT and patient nos.     At day 60     3-year overall survival   
        UCBT: 113   < 1-15 (5)   HLA-identical sibling   89 (26)   86 (44)*   14 (2) [5]   64   Comparison of UCBT and BMT from HLA-identical sibling donors.  
        BMT: 2052   < 1-15 (8)   HLA-identical sibling   98 (18)   96 (24)*   24 (10) [14]   66  

  1. There was a significantly longer time to platelet recovery in the early transplantation period (< 35 days) with UCBT

  2. Risk of acute and chronic GVHD was significantly lower with UCBT

  3. No significant difference in 100-day or 3-year survival observed between UCBT or BMT groups for either malignant or nonmalignant diseases

 
Ref no. 31         
    Type of HCT and patient nos.    % with mismatched grafts   At day 60     2-year DFS (relapse rate)   
        UBMT: 262   5-12 (8)   18%: 1 HLA-mm   96 (18)   85 (29)*   56 (29) [46]   43 (39)  

  1. Significant delay of neutrophil and platelet engraftment in UCBT group

  2. Neutrophil and platelet recovery correlated with nucleated cell dose (< 3.7 vs > 3.7 × 107 cells/kg) but not with HLA-disparity for UCBT

  3. Decreased acute GVHD in the UCBT and T-UBMT groups compared with UBMT group

 
        T-UBMT: 180   6-12 (8)   40%: 1-2 HLA-mm   90 (16)   85 (29)*   19 (8) [12]   37 (47)   
        UCBT: 99   2.5-10 (6)   89%: 1-3 HLA-mm   80 (32)   90 (81)*   33 (21) [25]   31 (38)   
Ref no. 34         
    Comparison groups (patient numbers)    HLA-6/6 match   At day 45     2-year overall survival   
        UCB vs BM-MTX (n = 26 each)   (4.5) vs (4.7)   19% vs 100%   88 (29) vs 96 (22)   72 (66) vs 76 (30)†   42 (19) vs 35 (8)   53 vs 41   Matched-pair analysis.  
        UCB vs BM-TCD (n = 31 each)
 		 (5.8) vs (6.8)
 		 13% vs 100%
 		 85 (27) vs 90 (14)
 		 84 (61) vs 84 (59)†
 		 36 (10) vs 35 (13)
 		 52 vs 56
 

  1. No difference in graft failure among comparison groups.

  2. Neutrophil recovery was significantly delayed in UCBT group vs BM-MTX or BM-TCD.

  3. No difference in acute/chronic GVHD in comparison groups

  4. Survival at 100 days/2 years was comparable between BM and UCB pairs

 

All series shown are in pediatric recipients only.

HLA-mm indicates HLAmismatch; UBMT, unmanipulated (unrelated) bone marrow transplantation; BM-MTX, T-replete bone marrow transplantation with methotrexate GVHD prophylaxis; T-UBMT or BM-TCD, T-cell—depleted unrelated bone marrow transplantation; myeloid engraftment, neutrophil count ≥ 0.5 × 109/L, first of 3 consecutive days; and platelet engraftment, ≥ 20 × 109 (untransfused) platelets/L, first of 7 days* or 14 days† free of platelet transfusions.

View Large
Close Modal
This Feature Is Available To Subscribers Only

or Create an Account

Close Modal
Close Modal