{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:25:47Z","timestamp":1783574747556,"version":"3.55.0"},"reference-count":52,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T00:00:00Z","timestamp":1690329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Measurable residual disease (MRD) status before transplantation has been shown to be a strong prognostic factor in patients with Philadelphia chromosome\u2010positive acute lymphoblastic leukemia (Ph<jats:sup>+<\/jats:sup> ALL). However, the outcomes of unrelated hematopoietic stem cell transplantation based on the MRD status have not been fully investigated. In this retrospective study, we compared the outcomes of 715 consecutive adults with Ph<jats:sup>+<\/jats:sup> ALL in complete remission who underwent unrelated cord blood transplantation (UCBT) (single\u2010unit UCBT, <jats:italic>n<\/jats:italic>\u2009=\u2009232 [4\/6, 5\/6, and 6\/6 HLA match]), HLA\u2010matched unrelated bone marrow transplantation (UBMT; <jats:italic>n<\/jats:italic>\u2009=\u2009292 [8\/8 HLA match]), or HLA\u2010mismatched UBMT (<jats:italic>n<\/jats:italic>\u2009=\u2009191 [7\/8 HLA match]). In the MRD<jats:sup>+<\/jats:sup> cohort, adjusted 3\u2010year leukemia\u2010free survival rates were 59.8%, 38.3%, and 55.5% after UCBT, HLA\u2010matched UBMT, and HLA\u2010mismatched UBMT, respectively. In the MRD<jats:sup>\u2212<\/jats:sup> cohort, the corresponding rates were 65.3%, 70.4%, and 69.7%, respectively. The MRD<jats:sup>+<\/jats:sup> HLA\u2010matched UBMT group had a significantly higher risk of relapse than the MRD<jats:sup>+<\/jats:sup> HLA\u2010mismatched UBMT group (hazard ratio [HR] in the MRD<jats:sup>+<\/jats:sup> HLA\u2010mismatched UBMT group, 0.33; 95% confidence interval [CI] 0.15\u20130.74) and the MRD<jats:sup>+<\/jats:sup> UCBT group (HR in the MRD<jats:sup>+<\/jats:sup> UCBT group, 0.38; 95% CI 0.18\u20130.83). Furthermore, HLA\u2010matched UBMT had a significant effect of MRD on death (HR 1.87; 95% CI 1.19\u20132.94), relapse or death (HR 2.24; 95% CI 1.50\u20133.34), and relapse (HR 3.12; 95% CI 1.75\u20135.57), while UCBT and HLA\u2010mismatched UBMT did not. In conclusion, our data indicate Ph<jats:sup>+<\/jats:sup> ALL patients with positive MRD may benefit from undergoing UCBT or HLA\u2010mismatched UBMT instead of HLA\u2010matched UBMT to reduce leukemic relapse.<\/jats:p>","DOI":"10.1002\/ajh.27041","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T11:48:41Z","timestamp":1690372121000},"page":"1606-1618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of <scp>MRD<\/scp> on clinical outcomes of unrelated hematopoietic stem cell transplantation in patients with Ph<sup>+<\/sup><scp>ALL<\/scp>: A retrospective nationwide study"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6684-9432","authenticated-orcid":false,"given":"Shigeki","family":"Hirabayashi","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8959-6271","authenticated-orcid":false,"given":"Tadakazu","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Nishiwaki","sequence":"additional","affiliation":[{"name":"Department of Advanced Medicine Nagoya University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Mizuta","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Immunology Kanazawa Medical University  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Doki","sequence":"additional","affiliation":[{"name":"Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Hematopoietic Stem Cell Transplantation National Cancer Center Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5952-5926","authenticated-orcid":false,"given":"Naoyuki","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiyasu","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Department of Hematology Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4866-9307","authenticated-orcid":false,"given":"Yoshinobu","family":"Kanda","sequence":"additional","affiliation":[{"name":"Division of Hematology Jichi Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Imanaka","sequence":"additional","affiliation":[{"name":"Department of Hematology Hiroshima Red Cross Hospital &amp; 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