Single cord blood combined with HLA-mismatched third party donor cells: comparable results to matched unrelated donor transplantation in high-risk patients with hematologic disorders

Biol Blood Marrow Transplant. 2013 Jan;19(1):143-9. doi: 10.1016/j.bbmt.2012.08.019. Epub 2012 Sep 6.


Matched unrelated donor (MUD) transplantation is the first alternative in the absence of a matched sibling donor. For patients without a suitable adult donor, we have adopted the dual stem cell transplantation protocol consisting of cord blood (CB) in combination with CD34(+) cells from a third party HLA-mismatched donor. We analyzed the outcomes of patients undergoing both procedures in a single center. Starting in 2004, a total of 20 patients with high-risk disease underwent 22 dual transplants and 25 patients underwent myeloablative MUD transplantation. The 30-day cumulative incidence of neutrophil engraftment was similar in both groups (91% and 95%), with a median time to engraftment of 14 and 16 days, respectively. Grade II-IV acute graft-versus-host disease was more frequent in the MUD group (40% versus 5%). Except for a tendency toward a higher incidence of viral hemorrhagic cystitis in the dual transplantation group, posttransplantation infectious events were comparable in the 2 groups. The 3-year cumulative incidence rates of relapse (41% versus 44%) and nonrelapse mortality (30% versus 25%) were similar in the MUD and dual transplantation cohorts. Estimated 3-year overall survival and disease-free survival were 47% and 41%, respectively, with no survival advantage for either group. In our experience, dual transplantation offers survival rates comparable to those from myeloablative MUD transplantation with similar nonrelapse mortality rates.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Acute Disease
  • Adult
  • Cord Blood Stem Cell Transplantation*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Graft vs Host Disease / mortality
  • Graft vs Host Disease / therapy
  • HLA Antigens
  • Hematologic Neoplasms / mortality*
  • Hematologic Neoplasms / therapy*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Middle Aged
  • Siblings*
  • Survival Rate
  • Time Factors
  • Unrelated Donors*


  • HLA Antigens