Blood advances · 2024
Cord blood transplantation for adult mature lymphoid neoplasms in Europe and Japan.
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Watanabe Mizuki, Kanda Junya, Volt Fernanda, Ruggeri Annalisa, Suzuki Ritsuro, Rafii Hanadi, Kimura Fumihiko, Cappelli Barbara, Kondo Eisei, Scigliuolo Graziana Maria, Takahashi Satoshi, Kenzey Chantal, Rivera-Franco Monica M, Okamoto Shinichiro, Rocha Vanderson, Chevallier Patrice, Sanz Jaime, Fürst Sabine, Cornelissen Jan, Milpied Noel, Uchida Naoyuki, Sugio Yasuhiro, Kimura Takafumi, Ichinohe Tatsuo, Fukuda Takahiro, Mohty Mohamad, Peffault de Latour Régis, Atsuta Yoshiko, Gluckman Eliane
Аннотация
To clarify the different characteristics and prognostic factors of cord blood transplantation (CBT) in adult patients with lymphoid neoplasms in Europe and Japan, we conducted a collaborative study. Patients aged 18-75 years receiving their first CBT (Europe: single CBT, n = 192; double CBT, n = 304; Japan: single CBT, n = 1150) in 2000-2017 were analyzed. Fewer patients with Hodgkin lymphoma (Europe vs Japan, 26% vs 5%), and older patients (≥50 years) (39% vs 59%) with a higher refined disease risk index (rDRI) (high-very high: 49% vs 14%) were included in the Japanese registry. High-very high rDRI was associated with inferior overall survival (OS) (vs low rDRI, Europe: hazard ratio [HR], 1.87; P = .001; Japan: HR, 2.34; P < .001) with higher progression/relapse risks. Total body irradiation (TBI)-containing conditioning contributed to superior OS both in Europe (vs TBI-reduced-intensity conditioning [RIC], non-TBI-RIC: HR, 1.93; P < .001; non-TBI-Myeloablative conditioning [MAC]: HR, 1.90; P = .003) and Japan (non-TBI-RIC: HR, 1.71; P < .001; non-TBI-MAC: HR 1.50, P = .007). The impact of HLA mismatches (≥2) on OS differed (Europe: HR, 1.52; P = .007; Japan: HR, 1.18; P = .107). CBT for lymphoid neoplasms, especially in those with high rDRI showed poor outcomes despite all the different characteristics in both registries. TBI should be considered in conditioning regimens to improve these outcomes. The different impacts of HLA mismatches call attention to the fundamental differences among these populations.