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- Title
Umbilical cord blood transplantation in adults with advanced hodgkin's disease: high incidence of post-transplant lymphoproliferative disease.
- Authors
Piñana, José Luis; Sanz, Jaime; Esquirol, Albert; Martino, Rodrigo; Picardi, Alessandra; Barba, Pere; Parody, Rocio; Gayoso, Jorge; Montesinos, Pau; Guidi, Stefano; Terol, Maria José; Moscardó, Federico; Solano, Carlos; Arcese, William; Sanz, Miguel A.; Sierra, Jorge; Sanz, Guillermo
- Abstract
We report the outcome of 30 consecutive patients with Hodgkin disease ( HD) who underwent single-unit UCBT. Most (90%) patients had failed previous autologous hematopoietic stem cell transplantation. The conditioning regimens were based on combinations of thiotepa, busulfan, cyclophosphamide or fludarabine, and antithymocyte globulin. The cumulative incidence ( CI) of myeloid engraftment was 90% [95% confidence interval (C.I.), 74-98%] with a median of 18 d (range, 10-48). CI of acute graft-versus-host disease (Gv HD) grades II- IV was 30% (95% C.I., 17-44%), while the incidence of chronic GVHD was 42% (95% C.I., 23-77%). The non-relapse mortality ( NRM) at 100 d and 4 yr was 30% (95% C.I., 13-46%) and 47% (95% C.I., 29-65%), respectively. EBV-related post-transplant lymphoproliferative disease ( EBV- PTLD) accounted for more than one-third of transplant-related death, with an estimate incidence of 26% (95% C.I., 9-44). The incidence of relapse at 4 yr was 25% (95% C.I., 9-42%). Four-year event-free survival ( EFS) and overall survival ( OS) were 28% and 30%, respectively. Despite a high NRM and an unexpected high incidence of EBV- PTLD, UCBT in heavily pretreated HD patients is an option for patients lacking a suitable adult donor, provided the disease is not in refractory relapse.
- Subjects
HODGKIN'S disease; HEMATOPOIETIC stem cells; THIOTEPA; BUSULFAN; CYCLOPHOSPHAMIDE
- Publication
European Journal of Haematology, 2016, Vol 96, Issue 2, p128
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.12557