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- Title
Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia.
- Authors
Barker, Juliet N.; Fei, Mingwei; Karanes, Chatchada; Horwitz, Mitchell; Devine, Steven; Kindwall‐Keller, Tamila L.; Holter, Jennifer; Adams, Alexia; Logan, Brent; Navarro, Willis H.; Riches, Marcie
- Abstract
Double-unit cord blood ( CB) grafts may improve engraftment and relapse risk in adults with haematological malignancies. We performed a prospective high-dose myeloablative double-unit CB transplantation ( CBT) trial in adults with high-risk acute leukaemia or myelodysplasia ( MDS) between 2007 and 2011. The primary aim was to establish the 1-year overall survival in a multi-centre setting. Fifty-six patients (31 acute myeloid leukaemia, 19 acute lymphoblastic leukaemia, 4 other acute leukaemias, 2 myelodysplastic syndrome [ MDS]) were transplanted at 10 centres. The median infused total nucleated cell doses were 2·62 (larger unit) and 2·02 (smaller unit) x 107/kg. The cumulative incidence of day 100 neutrophil engraftment was 89% (95% confidence interval [ CI]: 80-96). Day 180 grade II- IV acute graft- versus-host disease ( GVHD) incidence was 64% (95% CI: 51-76) and 36% (95% CI: 24-49) of patients had chronic GVHD by 3-years. At 3-years post-transplant, the transplant-related mortality ( TRM) was 39% (95% CI: 26-52), and the 3-year relapse incidence was 11% (95% CI: 4-21). With a median 37-month (range 23-71) follow-up of survivors, the 3-year disease-free survival was 50% (95% CI: 37-63). Double-unit CBT is a viable alternative therapy for high-risk acute leukaemia/ MDS in patients lacking a matched unrelated donor. This is especially important for minority patients. The relapse incidence was low but strategies to ameliorate TRM are needed.
- Subjects
CORD blood transplantation; LEUKEMIA; DYSPLASIA; ALTERNATIVE medicine; MORTALITY; PATIENTS
- Publication
British Journal of Haematology, 2015, Vol 168, Issue 3, p405
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.13136