Comparison of outcomes after single or double cord blood transplantation in adults with acute leukemia using different types of myeloablative conditioning regimen, a retrospective study on behalf of Eurocord and the Acute Leukemia Working Party of EBMT
Por:
Ruggeri, A, Sanz, G, Bittencourt, H, Sanz, J, Rambaldi, A, Volt, F, Yakoub-Agha, I, Ribera, JM, Mannone, L, Sierra, J, Mohty, M, Solano, C, Nabhan, S, Arcese, W, Gluckman, E, Labopin, M, Rocha, V
Publicada:
1 abr 2014
Resumen:
We report outcomes after single (s) and double (d) umbilical cord blood transplantation (UCBT) after myeloablative conditioning (MAC) regimen for 239 patients transplanted for acute leukemia in first complete remission (CR1). All sUCBT patients received a total nucleated cell dose >2.5 x 10(7)/kg. Conditioning regimen for sUCBT was total body irradiation (TBI) 12 Gy-or busulfan (BU)based +/- fludarabine (Flu) (n = 68, group 1), thiotepa + BU + Flu (TBF) (n = 88, group 2), and for dUCBT it was TBI12 Gycyclophosphamide +/- Flu (n = 83, group 3). dUCBT recipients were younger, received higher cell dose and less frequently antithymocyte globulin. In multivariate analysis, we found similar neutrophil recovery among the three groups; however, acute graft-versus-host disease II-IV was higher in dUCBT compared with others. Non-relapse mortality and relapse incidence were not statistically different among the three groups. Leukemia-free survival was 30% for sUCBT using TBI-or BU-based MAC compared with 48% for sUCBT TBF and 48% for dUCBT (P = 0.02 and P = 0.03, respectively), and it was not statistically different between sUCBT with TBF and dUCBT. In conclusion, use of sUCBT with adequate cell dose (42.5 +/- 107/kg) and a specific conditioning regimen in the MAC setting results in similar outcomes as dUCBT. The choice of TBF conditioning regimen for sUCBT may improve results, and whether this regimen may be effective in dUCBT should be further analyzed.
Filiaciones:
Ruggeri, A:
Hop St Louis, AP HP, Eurocord, F-75010 Paris, France
Univ Paris 07, IUH, Paris, France
Univ Tor Vergata, Rome Transplant Network, Rome, Italy
Sanz, G:
Hosp Univ La Fe, Valencia, Spain
Bittencourt, H:
CHU St Justine, Montreal, PQ, Canada
Sanz, J:
Hosp Univ La Fe, Valencia, Spain
Rambaldi, A:
Osped Riuniti Bergamo, I-24100 Bergamo, Italy
Volt, F:
Hop St Louis, AP HP, Eurocord, F-75010 Paris, France
Univ Paris 07, IUH, Paris, France
Yakoub-Agha, I:
Hop Claude Huriez, Lille, France
Ribera, JM:
Hosp Badalona Germans Trias & Pujol, ICO, Jose Carreras Res Inst, Badalona, Spain
Mannone, L:
Hop Archet, Nice, France
Sierra, J:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Mohty, M:
UPMC, Hosp St Antoine, AP HP, Serv Hematol & Therapie Cellulaire,UMR S 938,CERE, Paris, France
Solano, C:
Hosp Clin Univ, Valencia, Spain
Nabhan, S:
Hop St Louis, AP HP, Eurocord, F-75010 Paris, France
Univ Paris 07, IUH, Paris, France
Arcese, W:
Univ Tor Vergata, Rome Transplant Network, Rome, Italy
Gluckman, E:
Hop St Louis, AP HP, Eurocord, F-75010 Paris, France
Univ Paris 07, IUH, Paris, France
Labopin, M:
UPMC, Hosp St Antoine, AP HP, Serv Hematol & Therapie Cellulaire,UMR S 938,CERE, Paris, France
Rocha, V:
Hop St Louis, AP HP, Eurocord, F-75010 Paris, France
Univ Paris 07, IUH, Paris, France
Churchill Hosp, Oxford Univ Hosp, Oxford OX3 7LJ, England
Bronze
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