1. Outcomes of haplo-cord versus dual cord transplants: a single-center retrospective analysis.
- Author
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Kent A, Gil KB, Jones MK, Linden B, Purev E, Haverkos B, Schwartz M, McMahon C, Amaya M, Smith CA, Bosma G, Abbott D, Rabinovitch R, Milgrom SA, Pollyea DA, and Gutman JA
- Abstract
Background: 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., Objectives: Our objective in this study is to assess for differences in the outcomes and adverse effects associated with HCTs vs DCTs., Study Design: 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., Results: With a median follow-up of 3.6 years among survivors, there was no difference in overall survival (3 year OS 65% DCT vs 63% HCT, p=1) or relapse free survival (3 year RFS 62% DCT vs 64% HCT, p=0.97) for all patients. Time to neutrophil recovery was faster in HCT recipients (median 17 vs 22 days, p=0.021), with no difference in platelet recovery to 20,000/μL (p=0.12). Median hospitalization for HCT recipients was 20 days versus 24 days for DCT recipients (p<0.0001). Engraftment syndrome treated with steroids occurred in 47/133 (35%) DCT recipients vs 42/70 (60%) HCT recipients (OR 0.37, p-value=0.001). There was a significant increase in grade 3-4 acute graft-versus-host-disease (aGVHD) in haplo-cord recipients (p=0.007), but no difference in grade 2-4 aGVHD (p=0.11), all chronic GVHD (cGVHD) (p=0.9), or moderate-severe cGVHD (p=0.3)., Conclusions: Our outcomes demonstrate faster engraftment and shorter hospitalization in HCTs relative to DCTs, but more engraftment syndrome and higher grade 3-4 aGVHD. When both are options, these factors should guide the choice between HCTs and DCTs., Competing Interests: Declaration of competing interest None, (Copyright © 2024. Published by Elsevier Inc.)- Published
- 2024
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