Combined cord blood and bone marrow transplantation from the same human leucocyte antigen-identical sibling donor for children with malignant and non-malignant diseases
Por:
Tucunduva, L, Volt, F, Cunha, R, Locatelli, F, Zecca, M, Yesilipek, A, Caniglia, M, Gungor, T, Aksoylar, S, Fagioli, F, Bertrand, Y, Addari, MC, de la Fuente, J, Winiarski, J, Biondi, A, Sengeloev, H, Badell, I, Mellgren, K, de Heredia, CD, Sedlacek, P, Vora, A, Rocha, V, Ruggeri, A, Gluckman, E
Publicada:
1 abr 2015
Resumen:
Umbilical cord blood (UCB) from an human leucocyte antigen (HLA)-identical sibling can be used for transplantation of patients with malignant and non-malignant diseases. However, the low cellular content of most UCB units represents a limitation to this approach. An option to increase cell dose is to harvest bone marrow (BM) cells from the same donor and infuse them along with the UCB. We studied 156 children who received such a combined graft between 1992 and 2011. Median age was 7years and 78% of patients (n=122) were transplanted for non-malignant diseases, mainly haemoglobinopathies. Acute leukaemia (n=26) was the most frequent malignant diagnosis. Most patients (91%) received myeloablative conditioning. Median donor age was 17years, median infused nucleated cell dose was 244x10(7)/kg and median follow-up was 41months. Sixty-days neutrophil recovery occurred in 96% of patients at a median of 17d. The probabilities of grade-II-IV acute and chronic graft-versus-host disease (GVHD) were 19% and 10%, respectively. Four-year overall survival was 90% (68% malignant; 97% non-malignant diseases) with 3% probability of death. In conclusion, combined UCB and BM transplantation from an HLA-identical sibling donor is an effective treatment for children with malignant and non-malignant disorders with high overall survival and low incidence of GVHD.
Filiaciones:
Tucunduva, L:
Hosp St Louis, AP HP, Paris, France
IUH Univ Paris 7, Eurocord, Paris, France
Hosp Sirio Libanes, Ctr Oncol, Sao Paulo, Brazil
Volt, F:
Hosp St Louis, AP HP, Paris, France
IUH Univ Paris 7, Eurocord, Paris, France
Cunha, R:
Hosp St Louis, AP HP, Paris, France
IUH Univ Paris 7, Eurocord, Paris, France
Locatelli, F:
Univ Pavia, IRCSS, Dipartimento Oncoematol Pediat, Osped Bambino Gesu, Rome, Italy
Zecca, M:
Fdn IRCCS Policlin San Matteo, Pavia, Italy
Yesilipek, A:
Akdeniz Univ, Sch Med, TR-07058 Antalya, Turkey
Caniglia, M:
Univ Perugia, Dipartimento Med Clin & Sperimentale, I-06100 Perugia, Italy
Gungor, T:
Univ Childrens Hosp, Stem Cell Transplantat Dept, Zurich, Switzerland
Aksoylar, S:
Ege Univ, Izmir, Turkey
Fagioli, F:
Osped Infantile Regina Margherita Oncoematol Pedi, Turin, Italy
Ctr Trapianti, Turin, Italy
Bertrand, Y:
Inst Hematol & Oncol Pediat Lyon, Lyon, France
Addari, MC:
Ctr Trapianti Midollo Osseo Osped Microcitem, Cagliari, Italy
de la Fuente, J:
St Marys Hosp, Div Paediat, London, England
Winiarski, J:
Karolinska Inst, Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Stockholm, Sweden
Biondi, A:
Univ Milano Bicocca, Fdn MBBM, Clin Pediat, Osped San Gerardo, Monza, Italy
Sengeloev, H:
Rigshosp, DK-2100 Copenhagen, Denmark
Badell, I:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Mellgren, K:
Queen Silvias Hosp Children & Adolescents, Gothenburg, Sweden
de Heredia, CD:
Hosp Valle De Hebron, Barcelona, Spain
Sedlacek, P:
Univ Hosp Motol, Prague, Czech Republic
Vora, A:
Sheffield Childrens Hosp, Sheffield, S Yorkshire, England
Rocha, V:
Hosp St Louis, AP HP, Paris, France
IUH Univ Paris 7, Eurocord, Paris, France
Oxford Univ Hosp NHS Trust, Dept Clin Haematol, Oxford, England
Ruggeri, A:
Hosp St Louis, AP HP, Paris, France
IUH Univ Paris 7, Eurocord, Paris, France
Hosp St Antoine, AP HP, Serv Hematol & Therapie Cellulaire, Paris, France
Gluckman, E:
Hosp St Louis, AP HP, Paris, France
IUH Univ Paris 7, Eurocord, Paris, France
Ctr Sci Monaco, Monacord, Monaco, Monaco
Bronze, Green Submitted
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