{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:00:14Z","timestamp":1792047614035,"version":"4.4.0"},"reference-count":40,"publisher":"American Society of Hematology","issue":"9","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,5,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report graft-versus-host disease (GVHD)-free relapse-free survival (GRFS) (a composite end point of survival without grade III-IV acute GVHD [aGVHD], systemic therapy\u2013requiring chronic GVHD [cGVHD], or relapse) and cGVHD-free relapse-free survival (CRFS) among pediatric patients with acute leukemia (n = 1613) who underwent transplantation with 1 antigen\u2013mismatched (7\/8) bone marrow (BM; n = 172) or umbilical cord blood (UCB; n = 1441). Multivariate analysis was performed using Cox proportional hazards models. To account for multiple testing, P &amp;lt; .01 for the donor\/graft variable was considered statistically significant. Clinical characteristics were similar between UCB and 7\/8 BM recipients, because most had acute lymphoblastic leukemia (62%), 64% received total body irradiation\u2013based conditioning, and 60% received anti-thymocyte globulin or alemtuzumab. Methotrexate-based GVHD prophylaxis was more common with 7\/8 BM (79%) than with UCB (15%), in which mycophenolate mofetil was commonly used. The univariate estimates of GRFS and CRFS were 22% (95% confidence interval [CI], 16-29) and 27% (95% CI, 20-34), respectively, with 7\/8 BM and 33% (95% CI, 31-36) and 38% (95% CI, 35-40), respectively, with UCB (P &amp;lt; .001). In multivariate analysis, 7\/8 BM vs UCB had similar GRFS (hazard ratio [HR], 1.12; 95% CI, 0.87-1.45; P = .39), CRFS (HR, 1.06; 95% CI, 0.82-1.38; P = .66), overall survival (HR, 1.07; 95% CI, 0.80-1.44; P = .66), and relapse (HR, 1.44; 95% CI, 1.03-2.02; P = .03). However, the 7\/8 BM group had a significantly higher risk for grade III-IV aGVHD (HR, 1.70; 95% CI, 1.16-2.48; P = .006) compared with the UCB group. UCB and 7\/8 BM groups had similar outcomes, as measured by GRFS and CRFS. However, given the higher risk for grade III-IV aGVHD, UCB might be preferred for patients lacking matched donors.<\/jats:p>","DOI":"10.1182\/bloodadvances.2018030171","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T16:55:58Z","timestamp":1556902558000},"page":"1441-1449","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":20,"title":["GRFS and CRFS in alternative donor hematopoietic cell transplantation for pediatric patients with acute leukemia"],"prefix":"10.1182","volume":"3","author":[{"given":"Rohtesh S.","family":"Mehta","sequence":"first","affiliation":[{"name":"Division of Cancer Medicine, Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shernan G.","family":"Holtan","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for International Blood and Marrow Transplant Research and"},{"name":"Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Hemmer","sequence":"additional","affiliation":[{"name":"Center for International Blood and Marrow Transplant Research and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen R.","family":"Spellman","sequence":"additional","affiliation":[{"name":"Be the Match\/National Marrow Donor Program, Center for International Blood and Marrow Transplant Research, Minneapolis, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukta","family":"Arora","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Couriel","sequence":"additional","affiliation":[{"name":"Utah Blood and Marrow Transplant Program, Salt Lake City, UT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin M.","family":"Alousi","sequence":"additional","affiliation":[{"name":"Division of Cancer Medicine, Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Pidala","sequence":"additional","affiliation":[{"name":"Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, Tampa, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham","family":"Abdel-Azim","sequence":"additional","affiliation":[{"name":"Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5525-9798","authenticated-orcid":false,"given":"Ibrahim","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Hematology Oncology and Bone Marrow Transplantation, The Children's Mercy Hospitals and Clinics, Kansas City, MO;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Aljurf","sequence":"additional","affiliation":[{"name":"Department of Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi 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