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- Title
Risk factors for outcomes after unrelated cord blood transplantation for adults with acute lymphoblastic leukemia: a report on behalf of Eurocord and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.
- Authors
Tucunduva, L; Ruggeri, A; Sanz, G; Furst, S; Socié, G; Michallet, M; Arcese, W; Milpied, N; Yakoub-Agha, I; Linkesch, W; Cornelissen, J; Mannone, L; Iori, A P; Ribera, J-M; Sanz, J; Montesinos, P; Purtill, D; Labopin, M; Gluckman, E; Mohty, M
- Abstract
We performed a retrospective analysis on 421 adult patients who underwent unrelated cord blood transplantation (UCBT) for ALL. Median age was 32 years; 46% were in first CR (CR1), 32% in CR2 and 22% had advanced disease. Double UCBT was performed in 173 patients (41%). Myeloablative conditioning (MAC) was given to 314 patients (75%). Cumulative incidence (CI) of 60-day neutrophil recovery was 78%. CI of acute and chronic GVHD was 33 and 26%, respectively. Non-relapse mortality (NRM) at 2 years was 42%. Age⩾35 years (P<0.0001), advanced disease at UCBT (P<0.0001) and use of MAC (P<0.0001) were associated with increased NRM. Relapse incidence (RI) at 2 years was 28%; use of reduced intensity conditioning (RIC) (P=0.0002) was associated with increased RI. Two-year leukemia-free survival (LFS) was 39% for patients in CR1, 31% for CR2 and 8% for advanced disease. In multivariate analysis, factors associated with decreased LFS rate were: age ⩾35 years (P=0.034), use of MAC (P=0.032) and advanced disease (P<0.0001). These results show that UCBT is a valuable option to treat high-risk adult ALL when in remission. Strategies to decrease toxicity and relapse are needed to improve final outcomes.
- Subjects
CORD blood transplantation; LYMPHOBLASTIC leukemia; STEM cell transplantation; ACUTE leukemia; MULTIVARIATE analysis
- Publication
Bone Marrow Transplantation, 2014, Vol 49, Issue 7, p887
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2014.72