Umbilical cord blood transplantation from unrelated donors in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia
Por:
Pinana, JL, Sanz, J, Picardi, A, Ferra, C, Martino, R, Barba, P, Gonzalez-Vicent, M, Pascual, MJ, Martin, C, Verdeguer, A, de Heredia, CD, Montesinos, P, Ribera, JM, Sanz, M, Arcese, W, Sanz, G
Publicada:
1 feb 2014
Resumen:
There are very few disease-specific studies focusing on outcomes of umbilical cord blood transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. We report the outcome of 45 patients with Philadelphia chromosome-positive acute lymphoblastic leukemia who underwent myeloablative single unit cord blood transplantation from unrelated donors within the GETH/GITMO cooperative group. Conditioning regimens were based on combinations of thiotepa, busulfan, cyclophospamide or fludarabine, and antithymocyte globulin. At the time of transplantation, 35 patients (78%) were in first complete remission, four (8%) in second complete remission and six (14%) in third or subsequent response. The cumulative incidence of myeloid engraftment was 96% at a median time of 20 days and significantly better for patients receiving higher doses of CD34(+) cells. The incidence of acute grade II-IV graft-versus-host disease was 31%, while that of overall chronic graft-versus-host disease was 53%. Treatment-related mortality was 17% at day +100 and 31% at 5 years. The 5-year relapse, event-free survival and overall survival rates were 31%, 36% and 44%, respectively. Although the event-free and overall survival rates in patients without BCR/ABL transcripts detectable at time of transplant were better than those in whom BCR/ABL transcripts were detected (46% versus 24% and 60% versus 30%, respectively) these differences were not statistically significant in the univariate analysis (P=0.07). These results demonstrate that umbilical cord blood transplantation from unrelated donors can be a curative treatment for a substantial number of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia.
Filiaciones:
Pinana, JL:
Hosp Clin Univ, Dept Hematol, Valencia, Spain
Sanz, J:
Hosp Univ La Fe, Dept Hematol, Valencia, Spain
Picardi, A:
Univ Roma Tor Vergata, UOC Trapianto Cellule Staminali, Rome, Italy
Ferra, C:
ICO Hosp Univ Germans Trias & Pujol, Jose Carreras Res Inst, Dept Clin Hematol, Badalona, Spain
Martino, R:
Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain
Barba, P:
Hosp Univ Vall DHebron, Dept Hematol, Barcelona, Spain
Gonzalez-Vicent, M:
Hosp Nino Jesus, Dept Hematol, Madrid, Spain
Pascual, MJ:
Hosp Carlos Haya, Dept Hematol, Malaga, Spain
Martin, C:
Hosp Reina Sofia, Dept Hematol, Cordoba, Spain
Verdeguer, A:
Hosp Univ La Fe, Pediat Oncol Unit, Valencia, Spain
de Heredia, CD:
Hosp Univ Vall DHebron, Dept Pediat, Barcelona, Spain
Montesinos, P:
Hosp Univ La Fe, Dept Hematol, Valencia, Spain
Ribera, JM:
ICO Hosp Univ Germans Trias & Pujol, Jose Carreras Res Inst, Dept Clin Hematol, Badalona, Spain
Sanz, M:
Hosp Univ La Fe, Dept Hematol, Valencia, Spain
Univ Valencia, Dept Med, Valencia, Spain
Arcese, W:
Univ Roma Tor Vergata, UOC Trapianto Cellule Staminali, Rome, Italy
Sanz, G:
Hosp Univ La Fe, Dept Hematol, Valencia, Spain
Gold, Green Published
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