Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia

Clinical studies focused on outcomes of umbilical cord blood transplantation (UCBT) for patients with chronic myelogenous leukemia (CML) in need of allogeneic stem cell transplantation and lacking an HLA-matched adult donor are limited. We analyzed the outcome of 26 adults with CML receiving single-...

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Autores: Sanz, J, Montesinos, P, Saavedra, S, Lorenzo, I, Senent, L, Planelles, D, Larrea, L, Martin, G, Palau, J, Jarque, I, Martinez, J, de la Rubia, J, Moscardo, F, Martinez, D, Gomez, I, Lopez, M, Sanz, MA, Sanz, GF
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2010
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p14135
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/14135
Access Level:acceso abierto
Palabra clave:UCBT
Transplantation
CML
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spelling Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous LeukemiaSanz, JMontesinos, PSaavedra, SLorenzo, ISenent, LPlanelles, DLarrea, LMartin, GPalau, JJarque, IMartinez, Jde la Rubia, JMoscardo, FMartinez, DGomez, ILopez, MSanz, MASanz, GFUCBTTransplantationCMLClinical studies focused on outcomes of umbilical cord blood transplantation (UCBT) for patients with chronic myelogenous leukemia (CML) in need of allogeneic stem cell transplantation and lacking an HLA-matched adult donor are limited. We analyzed the outcome of 26 adults with CML receiving single-unit UCBT from unrelated donors after myeloablative conditioning at a single institution. Conditioning regimens were based on combinations of thiotepa, busulfan, cyclophospamide or fludarabine, and antithymocyte globulin. At the time of transplantation, 7 patients (27%) were in first chronic phase (CP), I I (42%) were in second CP, 2 (8%) were in accelerated phase (AP), and 6 (23%) were in blast crisis (BC). The cumulative incidence (Cl) of myeloid engraftment was 88% at a median time of 22 days and was significantly better for patients receiving higher doses of CD34(+) cells. The Cl of acute graft-versus-host disease (GVHD) grade II-IV was 61%, that of acute GVHD grade III-IV was 39%, and that of chronic extensive GVHD was 60%. Treatment-related mortality (TRM) was 41% for patients undergoing UCBT while in first or second CP and 100% for patients in AP or BC (P < .01). After a median follow-up of 8 years, none of the patients relapsed, giving an overall disease-free survival (DFS) at 8 years of 41%. The DES for patients undergoing UCBT while in any CP was 59%. These results demonstrate that UCBT from unrelated donors can be a curative treatment for a substantial number of patients with CML. Advances in supportive care and better selection of cord blood units and patients are needed to improve TRM.ELSEVIER SCIENCE INC2010info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/14135BIOLOGY OF BLOOD AND MARROW TRANSPLANTATIONISSN: 10838791ISSNe: 15236536reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p141352026-06-11T12:45:17Z
dc.title.none.fl_str_mv Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia
title Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia
spellingShingle Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia
Sanz, J
UCBT
Transplantation
CML
title_short Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia
title_full Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia
title_fullStr Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia
title_full_unstemmed Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia
title_sort Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia
dc.creator.none.fl_str_mv Sanz, J
Montesinos, P
Saavedra, S
Lorenzo, I
Senent, L
Planelles, D
Larrea, L
Martin, G
Palau, J
Jarque, I
Martinez, J
de la Rubia, J
Moscardo, F
Martinez, D
Gomez, I
Lopez, M
Sanz, MA
Sanz, GF
author Sanz, J
author_facet Sanz, J
Montesinos, P
Saavedra, S
Lorenzo, I
Senent, L
Planelles, D
Larrea, L
Martin, G
Palau, J
Jarque, I
Martinez, J
de la Rubia, J
Moscardo, F
Martinez, D
Gomez, I
Lopez, M
Sanz, MA
Sanz, GF
author_role author
author2 Montesinos, P
Saavedra, S
Lorenzo, I
Senent, L
Planelles, D
Larrea, L
Martin, G
Palau, J
Jarque, I
Martinez, J
de la Rubia, J
Moscardo, F
Martinez, D
Gomez, I
Lopez, M
Sanz, MA
Sanz, GF
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv UCBT
Transplantation
CML
topic UCBT
Transplantation
CML
description Clinical studies focused on outcomes of umbilical cord blood transplantation (UCBT) for patients with chronic myelogenous leukemia (CML) in need of allogeneic stem cell transplantation and lacking an HLA-matched adult donor are limited. We analyzed the outcome of 26 adults with CML receiving single-unit UCBT from unrelated donors after myeloablative conditioning at a single institution. Conditioning regimens were based on combinations of thiotepa, busulfan, cyclophospamide or fludarabine, and antithymocyte globulin. At the time of transplantation, 7 patients (27%) were in first chronic phase (CP), I I (42%) were in second CP, 2 (8%) were in accelerated phase (AP), and 6 (23%) were in blast crisis (BC). The cumulative incidence (Cl) of myeloid engraftment was 88% at a median time of 22 days and was significantly better for patients receiving higher doses of CD34(+) cells. The Cl of acute graft-versus-host disease (GVHD) grade II-IV was 61%, that of acute GVHD grade III-IV was 39%, and that of chronic extensive GVHD was 60%. Treatment-related mortality (TRM) was 41% for patients undergoing UCBT while in first or second CP and 100% for patients in AP or BC (P < .01). After a median follow-up of 8 years, none of the patients relapsed, giving an overall disease-free survival (DFS) at 8 years of 41%. The DES for patients undergoing UCBT while in any CP was 59%. These results demonstrate that UCBT from unrelated donors can be a curative treatment for a substantial number of patients with CML. Advances in supportive care and better selection of cord blood units and patients are needed to improve TRM.
publishDate 2010
dc.date.none.fl_str_mv 2010
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/14135
url https://fisabio.portalinvestigacion.com/publicaciones/14135
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
ISSN: 10838791
ISSNe: 15236536
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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