Single-unit umbilical cord blood transplantation from unrelated donors in patients with hematological malignancy using busulfan, thiotepa, fludarabine and ATG as myeloablative conditioning regimen
Por:
Sanz, J, Boluda, JCH, Martin, C, Gonzalez, M, Ferra, C, Serrano, D, de Heredia, CD, Barrenetxea, C, Martinez, AM, Solano, C, Sanz, MA and Sanz, GF
Publicada:
1 oct 2012
Resumen:
Attempts to optimize outcomes in cord blood transplantation (CBT) by using new conditioning regimens and standardization of cord blood unit selection are warranted. In all, 88 patients (18 children and 70 adults) with hematological malignancy from nine Spanish institutions underwent a single-unit CBT after an i.v. BU-based myeloablative conditioning regimen. All evaluable patients except one engrafted. The overall cumulative incidence (CI) of myeloid engraftment was 94% at a median time of 19 days. In multivariate analysis, nonadvanced disease stage was the only factor with a favorable impact on myeloid engraftment. The CI of acute GVHD grades II-IV and chronic extensive GVHD were 24% each. The CI of nonrelapse mortality at 100 days, 180 days and 5 years was 14, 23 and 44%, respectively. The 5-year CI of relapse was 18%, whereas disease-free survival (DFS) was 46%, 39% and 11% for patients transplanted in early, intermediate and advanced stages of the disease, respectively. Our study shows high rates of engraftment with fast neutrophil recovery in patients undergoing single-unit CBT using a BU-based conditioning regimen. Long-term DFS can be achieved in a substantial number of patients with high-risk hematological malignancies, particularly when transplanted in an early stage of the disease.
Filiaciones:
Sanz, J:
Hosp Univ La Fe, Dept Hematol, Valencia 46026, Spain
Boluda, JCH:
Hosp Clin Univ, Valencia, Spain
Martin, C:
Hosp Reina Sofia, Cordoba, Spain
Gonzalez, M:
Hosp Nino Jesus, Madrid, Spain
:
Hosp Badalona Germans Trias & Pujol, Barcelona, Spain
Serrano, D:
Hosp Gen Gregorio Maranon, Madrid, Spain
de Heredia, CD:
Hosp Infantil Vall DHebron, Barcelona, Spain
Barrenetxea, C:
Hosp Univ Vall dHebron, Barcelona, Spain
Martinez, AM:
Hosp La Paz Infantil, Madrid, Spain
Solano, C:
Hosp Clin Univ, Valencia, Spain
Sanz, MA:
Hosp Univ La Fe, Dept Hematol, Valencia 46026, Spain
Sanz, GF:
Hosp Univ La Fe, Dept Hematol, Valencia 46026, Spain
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