ArticleBone marrow transplantation2026
Comparative outcomes of umbilical cord blood transplantation versus haploidentical transplantation according to post-transplant cyclophosphamide use in adolescent and young adult patients.
Article in Bone marrow transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
23 authors.
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Abstract
Comparative data on alternative donor platforms in adolescent and young adult (AYA) allogeneic hematopoietic cell transplantation (HCT) are limited. We conducted a nationwide retrospective registry study in Japan comparing unrelated umbilical cord blood transplantation (UCBT), haploidentical transplantation without post-transplant cyclophosphamide (non-PTCy-haplo), and PTCy-based haploidentical transplantation (PTCy-haplo). The study included 458 patients aged 16-25 years (UCBT, n = 101; non-PTCy-haplo, n = 132; PTCy-haplo, n = 225). The main endpoints were overall survival (OS) and relapse-free survival (RFS); relapse, non-relapse mortality (NRM), graft-versus-host disease (GVHD), and engraftment were also evaluated. UCBT showed the most favorable survival. In multivariable analyses, non-PTCy-haplo was associated with inferior OS and RFS, higher NRM, and a higher incidence of grade II-IV acute GVHD than UCBT. PTCy-haplo was associated with inferior OS versus UCBT but showed no significant differences in RFS, relapse, NRM, acute GVHD, or chronic GVHD. Both haploidentical platforms showed faster neutrophil engraftment than UCBT, and PTCy-haplo also showed faster platelet engraftment. Sensitivity analyses restricted to malignant disease and stratified by conditioning intensity supported these findings. In this AYA cohort, UCBT was associated with the most favorable survival, non-PTCy-haplo showed consistently inferior outcomes, and PTCy-haplo remained a practical alternative when rapid donor availability and early hematopoietic recovery are prioritized.
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