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Treatment of leukemia with transplantation of allogeneic bone marrow or stem cells from the peripheral blood is limited by the poor number of HLA-matched related donors. The purpose of this study was to conduct a retrospective analysis of outcomes in patients with Acute Lymphoid Leukemia (n=185), Acute Myeloid Leukemia (n=300) or Myelodysplastic Syndrome (n=97), who either received a transplant from a cord-blood donor (n=140), a HLA-matched unrelated donor (n=344) or from a HLA-mismatched unrelated donor (n=98).
Dr Filippo Milano and his colleagues from the Fred Hutchinson Cancer Research Centre, Seattle, USA, also analyzed if there was a difference in the relative risk of deaths and relapse between the cord-blood group and the other two unrelated donor groups with respect to numerous outcomes according to presence or absence of minimal residual disease (MRD) before transplantation. They published their data in the New England Journal of Medicine on the 8th of September 2016.
Even though the data analyzed here focuses on a cohort of patients based on clinical priority and non-randomization, it does provide evidence and guidance regarding difficult donor choices in circumstances where a HLA-identical sibling is not available. Future studies based on randomization would determine the differences between cord-blood and unrelated-donor transplantations.
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