Cord Blood Transplants Associated With Lower Rates of Graft-Versus-Host Disease Than Transplants from Matched, Unrelated Donors

The incidence of severe chronic graft-versus-host disease (cGVHD) at three years post-transplantation was significantly lower among patients who received transplants from matched, unrelated donors (MUD) than those who received adult umbilical cord blood transplants (CBT; 44% vs. 8%; p=0.0006), according to an article published in Bone Marrow Transplantation. Patients who received CBT were also more likely to no longer need immunosuppression and less likely to experience late infections (p=0.1) and hospitalizations (p<0.001). No differences in overall survival were observed.

Jonathan Gutman, MD, clinical director of allogeneic hematopoietic cell transplantation at the University of Colorado Hospital, and authors compared outcomes for patients receiving CBT (n=51) and MUD (n=57) who were consecutively enrolled between June 2009 and April 2014 at the University of Colorado Hospital and did not have matched related donors (MRDs). The cumulative incidence of any cGVHD was 68 percent following MUD versus 32 percent following CBT (p=0.0017) after three years post-transplantation. Patients receiving CBT had stopped immunosuppression for a median 268 days from transplant, while the median was not reached among those receiving MUD (p<0.0001).

“These findings have led our center to move primarily to [CBT] over peripheral blood MUD when a MRD is not available,” the authors concluded.

Source: Gutman JA, Ross K, Smith C, et al. Chronic graft versus host disease burden and late transplant complications are lower following adult double cord blood versus matched unrelated donor peripheral blood transplantation. Bone Marrow Transplant. 2016 July 11. [Epub ahead of print]