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Optimizing selection of double cord blood units for transplantation of adult patients with malignant diseases. Blood Adv 2021; 4:6327-6335. [PMID: 33351128 DOI: 10.1182/bloodadvances.2020002258] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/03/2020] [Indexed: 12/20/2022] Open
Abstract
Double-unit unrelated cord blood transplantation (DUCBT) is an option in patients for whom a single unit is not sufficient to provide an adequate number of cells. As current guidelines on UCB unit selection are mainly based on single-unit UCB data, we performed a retrospective analysis of 1375 adult recipients of DUCBT for hematologic malignancies to determine optimal criteria for graft selection. Cryopreserved total nucleated cells (TNCs; ≤3.5 vs >3.5 × 107/kg: hazard ratio [HR], 1.53; 30% vs 45%; P = .01), number of HLA mismatches (≥2 vs 0-1: HR, 1.28; 42% vs 48%; P = .01), and ABO compatibility (minor/major ABO incompatibility vs compatibility: HR, 1.28; P = .04) were independent risk factors for OS. Cryopreserved CD34+ cell dose ≥0.7 × 105/kg in the winning UCB was associated with improved OS (HR, 1.34; P = .03). Low TNC (≤3.5 × 107/kg) and CD34+ (≤1.4 × 105/kg) cell doses were related to decreased neutrophil recovery (HR, 0.65 [P = .01] and HR, 0.81 [P = .01], respectively). DUCBT recipients with ≥2 HLA mismatches had a higher incidence of grade II-IV and III-IV acute graft-versus-host disease (HR, 1.26 [P = .03] and 1.59 [P = .02], respectively). Low TNC dose (HR, 1.57; P = .02) and receiving UCB with ≥2 HLA mismatches (HR, 1.35; P = .03) were associated with increased transplant-related mortality. Our data support selecting adequately HLA-matched UCB units with a double-unit cryopreserved TNC dose >3.5 × 107/kg and CD34+ cell dose of ≥0.7 × 105/kg per unit in DUCBT candidates.
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2
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Politikos I, Davis E, Nhaissi M, Wagner JE, Brunstein CG, Cohen S, Shpall EJ, Milano F, Scaradavou A, Barker JN. Guidelines for Cord Blood Unit Selection. Biol Blood Marrow Transplant 2020; 26:2190-2196. [PMID: 32736011 DOI: 10.1016/j.bbmt.2020.07.030] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022]
Abstract
Optimal cord blood (CB) unit selection is critical to maximize the likelihood of successful engraftment and survival after CB transplantation (CBT). However, unit selection can be complex because multiple characteristics must be considered including unit cell dose, donor-recipient human leukocyte antigen (HLA) match, and unit quality. This review provides evidence-based and experience-based comprehensive guidelines for CB unit selection. Topics addressed include the use of both the TNC and the CD34+ cell dose, as well as the CD34+ cell to TNC content ratio to evaluate unit progenitor cell content and engraftment potential, the acceptable TNC and CD34+ cell dose criteria that define an adequate single-unit graft, and the indication and acceptable cell dose criteria for double-unit grafts. The acceptable criteria for 6-loci (HLA-A, -B antigen, -DRB1 allele) and 8-allele (HLA-A, -B, -C, -DRB1) donor-recipient HLA match, the evaluation of patients with donor-specific HLA antibodies, and the multiple determinants of unit quality are also reviewed in detail. Finally, a practical step-by-step guide to CB searches and the principles that guide ultimate graft selection are outlined.
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Affiliation(s)
- Ioannis Politikos
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Eric Davis
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Melissa Nhaissi
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - John E Wagner
- Blood and Marrow Transplant Program, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Claudio G Brunstein
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, Minnesota
| | - Sandra Cohen
- Division of Hematology, Department of Medicine, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
| | - Elizabeth J Shpall
- Department of Stem Cell Transplant and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Filippo Milano
- Clinical Research Division, Fred Hutchinson Cancer Research Center & Department of Medicine, University of Washington, Seattle, Washington
| | | | - Juliet N Barker
- Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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3
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Red blood cell transfusion burden by day 30 predicts mortality in adults after single-unit cord blood transplantation. Bone Marrow Transplant 2019; 54:1836-1846. [DOI: 10.1038/s41409-019-0555-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 11/08/2022]
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4
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Csanadi M, Agh T, Tordai A, Webb T, Jeyakumaran D, Sengupta N, Schain F, Mattsson J. A systematic literature review of incidence, mortality, and relapse of patients diagnosed with chronic graft versus host disease. Expert Rev Hematol 2019; 12:311-323. [DOI: 10.1080/17474086.2019.1605288] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Tamas Agh
- Syreon Research Institute, Budapest, Hungary
| | - Attila Tordai
- Department of Pathophysiology, Semmelweis University, Budapest, Hungary
| | - Thomas Webb
- Janssen Research & Development, High Wycombe, UK
| | | | | | | | - Jonas Mattsson
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
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5
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Kudek MR, Shanley R, Zantek ND, McKenna DH, Smith AR, Miller WP. Impact of Graft-Recipient ABO Compatibility on Outcomes after Umbilical Cord Blood Transplant for Nonmalignant Disease. Biol Blood Marrow Transplant 2016; 22:2019-2024. [PMID: 27496217 PMCID: PMC5067229 DOI: 10.1016/j.bbmt.2016.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/23/2016] [Indexed: 01/05/2023]
Abstract
Existing literature shows mixed conclusions regarding the impact of ABO incompatibility on outcomes after hematopoietic stem cell transplantation. Because the future for umbilical cord blood (UCB) expansion technologies is bright, we assessed whether this typically overlooked graft characteristic impacted various outcomes after UCB transplantation (UCBT) for nonmalignant disorders (NMDs). A prospectively maintained institutional blood and marrow transplant program database was queried for all patients undergoing first UCBT for NMDs. UCB and recipient ABO compatibility was considered as matched, major mismatched, minor mismatched, or bidirectional mismatched. The impact of ABO incompatibility was assessed on overall survival, graft failure, acute and chronic graft-versus-host disease (GVHD), time to neutrophil and platelet recovery, day 0 to day 100 RBC transfusion burden, and donor hematopoietic chimerism. Through December 2014, 270 patients have undergone first UCBT for various NMDs. In both univariable and multivariable analyses, ABO compatibility status did not appear to impact any outcomes assessed, although a trend toward increased grades III to IV acute GVHD was seen in recipients of major mismatched units. When considering UCBT for treatment of NMDs, ABO compatibility between the donor unit and intended recipient does not appear to be an important consideration in the UCB unit choice.
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Affiliation(s)
- Matthew R Kudek
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
| | - Ryan Shanley
- Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Nicole D Zantek
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - David H McKenna
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Angela R Smith
- Division of Pediatric Blood and Marrow Transplantation, University of Minnesota, Minneapolis, Minnesota
| | - Weston P Miller
- Division of Pediatric Blood and Marrow Transplantation, University of Minnesota, Minneapolis, Minnesota
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Tsang KS, Leung AWK, Lee V, Cheng FWT, Shing MMK, Pong HNH, Leung TF, Yuen PMP, Li CK. Indiscernible Benefit of Double-Unit Umbilical Cord Blood Transplantation in Children: A Single-Center Experience from Hong Kong. Cell Transplant 2016; 25:1277-86. [DOI: 10.3727/096368915x689631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Double-unit umbilical cord blood (DU-UCB) may extend the use of UCB transplantation and improve clinical outcomes. Data in the literature show that single-unit dominance happened in a vast majority of recipients, and the mechanism is unknown. We examined the clinical relevance and engraftment kinetics of DU-UCB transplant in 65 consecutive children who underwent unrelated single-unit ( n = 25) and double-unit ( n = 40) UCB transplantation for various hematological malignancies ( n = 45) and nonmalignant disorders ( n = 20). Our result showed no discernible benefit to children receiving double-unit transplant over those receiving single-unit transplant when the total nucleated cell (TNC) doses are ≥2.5 × 107/kg, in terms of the hastening of the engraftment of neutrophils and platelets, reduction of nonengraftment, disease recurrence, early mortality, and graft-versus-host disease, despite significantly higher numbers of TNCs in double units. Further analyses demonstrated that the phenomena were not associated with underlying disease, duration of UCB storage, postthaw viability, HLA disparity, ABO incompatibility, gender, or doses of TNCs, CD34+ cells, CD3+ cells, or colony-forming units. Engrafting units in DU-UCB transplants were notably associated with higher CD34+ cell dose. Chimerism studies demonstrated that single-unit dominance started before neutrophil engraftment in DU-UCB transplants. Data from the study suggested no advantage of infusing double-unit UCB, if an adequately dosed single-unit UCB is available. Successful prediction of the dominant graft would optimize algorithms of UCB selection and maximize the long-term engraftment of chosen units.
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Affiliation(s)
- Kam Sze Tsang
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Alex Wing Kwan Leung
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Vincent Lee
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Frankie Wai Tsoi Cheng
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Matthew Ming Kong Shing
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Henry Nga Hin Pong
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Ting Fan Leung
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Patrick Man Pan Yuen
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Chi Kong Li
- Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
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Yan J, Sun G, Zhang L, Yao W, Zhu X, Tang B, Zheng C, Liu H, Sun Z. [Impacts of ABO incompatibility on early outcome after single unit unrelated cord blood transplantation: a retrospective single center experience]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2015; 36:999-1004. [PMID: 26759100 PMCID: PMC7342320 DOI: 10.3760/cma.j.issn.0253-2727.2015.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To retrospectively study the impacts of ABO incompatibility on early outcome after single unit unrelated cord blood transplantation(UCBT), such as cumulative incidence of engraftment, incidence of acute graft- versus- host disease (aGVHD) and 180- day transplant- related mortality(TRM). METHODS 208 patients underwent single unit UCBT from April 2008 to October 2014 were analyzed, included 99 ABO- identical, 60 minor, 38 major and 11 bidirectional ABO- incompatible recipients. All the patients received intensified myeloablative conditioning, and a combination of cyclosporine A and mycophenolate mofetil was given for GVHD prophylaxis. RESULTS Cumulative incidences of neutrophil engraftment, platelet recovery, erythroid lineage reconstitution, Ⅱ-Ⅳ aGVHD, Ⅲ-Ⅳ aGVHD and 180- day TRM showed no significant difference among the patients receiving ABOidentical, minor, major, and bidirectional UCBT(all P>0.05, respectively). What's more, none of the patients developed pure red- cell aplasia(PRCA)after UCBT. Group A donor and a group O recipient patients didn't appeared to influence the clinical results when compared with others(all P>0.05, respectively). CONCLUSION Patients receive ABO- incompatible UCBT may not develop PRCA. The presence of ABO- incompatibility did not influence the hematopoietic reconstitution, the incidence of aGVHD and 180-day TRM in this cohort. There is not support for the need to regard ABO-compatibility as an UCB-graft selection criterion.
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Affiliation(s)
- Jiawei Yan
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
| | - Guangyu Sun
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
| | - Lei Zhang
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
| | - Wen Yao
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
| | - Xiaoyu Zhu
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
| | - Baolin Tang
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
| | - Changcheng Zheng
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
| | - Huilan Liu
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
| | - Zimin Sun
- Department of Hematology, Affiliated Provincial Hospital, Anhui Medical University, Hefei 230001, China
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8
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Risk factors and prognosis of hepatic acute GvHD after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2015; 51:96-102. [PMID: 26367230 DOI: 10.1038/bmt.2015.205] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 07/19/2015] [Accepted: 07/24/2015] [Indexed: 01/01/2023]
Abstract
Hepatic acute GvHD (aGvHD) is associated with high mortality owing to poor response to immunosuppressive therapy. The pathogenesis of hepatic aGvHD differs from that of other lesions, and specific risk factors related to pre-transplant liver conditions should be determined. We conducted a cohort study by using a Japanese transplant registry database (N=8378). Of these subjects, 1.5% had hepatitis C virus Ab (HCV-Ab) and 9.4% had liver dysfunction (elevated transaminase or bilirubin levels) before hematopoietic cell transplantation (HCT). After HCT, the cumulative incidence of hepatic aGvHD was 6.7%. On multivariate analyses, HCV-Ab positivity (hazard ratio (HR), 1.93; P=0.02) and pre-transplant liver dysfunction (HR, 1.85; P<0.01), as well as advanced HCT risk, unrelated donors, HLA mismatch and cyclosporine as GvHD prophylaxis, were significant risk factors for hepatic aGvHD, whereas hepatitis B virus surface Ag was not. Hepatic aGvHD was a significant risk factor for low overall survival and high transplant-related mortality in all aGvHD grades (P<0.01). This study is the first to show the relationship between pre-transplant liver conditions and hepatic aGvHD. A prospective study is awaited to validate the results of this study and establish a new strategy especially for high-risk patients.
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9
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Wu S, Xie G, Wu J, Chen J, Lu Y, Li Y, Tang X, Liao C. Influence of maternal, infant, and collection characteristics on high-quality cord blood units in Guangzhou Cord Blood Bank. Transfusion 2015; 55:2158-67. [DOI: 10.1111/trf.13126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 03/06/2015] [Accepted: 03/10/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Shaoqing Wu
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Guie Xie
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Jieying Wu
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Jingsong Chen
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Yan Lu
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Yan Li
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Xuewei Tang
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
| | - Can Liao
- Guangzhou Cord Blood Bank; Guangzhou Women and Children's Medical Center; Guangzhou Medical University; Guangzhou Guangdong China
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10
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Brierley CK, Littlewood TJ, Peniket AJ, Gregg R, Ward J, Clark A, Parker A, Malladi R, Medd P. Impact of ABO blood group mismatch in alemtuzumab-based reduced-intensity conditioned haematopoietic SCT. Bone Marrow Transplant 2015; 50:931-8. [PMID: 25867645 DOI: 10.1038/bmt.2015.51] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 09/21/2014] [Accepted: 09/25/2014] [Indexed: 01/19/2023]
Abstract
The impact of ABO incompatibility on clinical outcomes following haematopoietic SCT (HSCT) remains controversial. This retrospective study assessed the effect of ABO mismatch on transplant outcomes and transfusion requirements in 594 patients undergoing reduced-intensity conditioned (RIC) HSCT with alemtuzumab in three UK transplant centres. We found no significant effects of minor, major or bidirectional ABO mismatch on overall survival, relapse-free survival, nonrelapse mortality or relapse incidence. Although the rate of acute GVHD was unaffected by ABO mismatch, the incidence of extensive chronic GVHD was higher in patients with minor and major mismatch compared with those who were ABO matched (hazard ratio (HR) 1.74, P=0.032 for minor, HR 1.69 P=0.0036 for major mismatch). Red cell and platelet transfusion requirements in the first 100 days post transplant did not differ by ABO mismatch. In this large UK series, ABO mismatch in RIC HSCT has no clinically significant effect on survival outcomes but appears to modify susceptibility to extensive chronic GVHD.
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Affiliation(s)
- C K Brierley
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - T J Littlewood
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - A J Peniket
- Department of Haematology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - R Gregg
- Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - J Ward
- Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - A Clark
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - A Parker
- Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - R Malladi
- Centre for Clinical Haematology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - P Medd
- Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK
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11
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Rio B, Chevret S, Vigouroux S, Chevallier P, Fürst S, Sirvent A, Bay JO, Socié G, Ceballos P, Huynh A, Cornillon J, Françoise S, Legrand F, Yakoub-Agha I, Michel G, Maillard N, Margueritte G, Maury S, Uzunov M, Bulabois CE, Michallet M, Clement L, Dauriac C, Bilger K, Gluckman E, Ruggeri A, Buzyn A, Nguyen S, Simon T, Milpied N, Rocha V. Decreased nonrelapse mortality after unrelated cord blood transplantation for acute myeloid leukemia using reduced-intensity conditioning: a prospective phase II multicenter trial. Biol Blood Marrow Transplant 2014; 21:445-53. [PMID: 25460357 DOI: 10.1016/j.bbmt.2014.11.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 11/07/2014] [Indexed: 01/27/2023]
Abstract
A prospective phase II multicenter trial was performed with the aim to obtain less than 25% nonrelapse mortality (NRM) after unrelated cord blood transplantation (UCBT) for adults with acute myeloid leukemia (AML) using a reduced-intensity conditioning regimen (RIC) consisting of total body irradiation (2 Gy), cyclophosphamide (50 mg/kg), and fludarabine (200 mg/m(2)). From 2007 to 2009, 79 UCBT recipients were enrolled. Patients who underwent transplantation in first complete remission (CR1) (n = 48) had a higher frequency of unfavorable cytogenetics and secondary AML and required more induction courses of chemotherapy to achieve CR1 compared with the others. The median infused total nucleated cells (TNC) was 3.4 × 10(7)/kg, 60% received double UCBT, 77% were HLA mismatched (4/6), and 40% had major ABO incompatibility. Cumulative incidence of neutrophil recovery at day 60 was 87% and the cumulative incidence of 100-day acute graft-versus-host disease (II to IV) was 50%. At 2 years, the cumulative incidence of NRM and relapse was 20% and 46%, respectively. In multivariate analysis, major ABO incompatibility (P = .001) and TNC (<3.4 × 10(7)/kg; P = .001) were associated with increased NRM, and use of 2 or more induction courses to obtain CR1 was associated with increased relapse incidence (P = .04). Leukemia-free survival (LFS) at 2 years was 35%, and the only factor associated with decreased LFS was secondary AML (P = .04). In conclusion, despite the decreased NRM observed, other RIC regimens with higher myelosuppression should be evaluated to decrease relapse in high-risk AML. (EUDRACT 2006-005901-67).
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Affiliation(s)
- Bernard Rio
- Service d'Hématologie, Hôtel-Dieu Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sylvie Chevret
- Department de Bioinformatique et Statistique Médicale, Hopital Saint-Louis, Paris, France
| | - Stéphane Vigouroux
- Service d'Hématologie, Service d'Hématologie clinique et de thérapie cellulaire, CHU de Bordeaux Hopital du Haut-Lévèque, Pessac, France
| | - Patrice Chevallier
- Service d'Hématologie, Hematology Department, CHU de Nantes, Nantes, France
| | - Sabine Fürst
- Service d'Hématologie, Service de Greffe de Moelle, Institut Paoli Calmettes, Marseille, France
| | - Anne Sirvent
- Service d'Hématologie, Hematologie Clinique, Hopital de l'Archet I, Nice, France
| | - Jacques-Olivier Bay
- Service d'Hématologie, Service d'Hématologie Clinique, CHU Estaing, Clermont-Ferrand, France
| | - Gérard Socié
- Service d'Hématologie, Hematology-Bone Marrow Transplantation, Hopital Saint-Louis, Paris, France
| | | | - Anne Huynh
- Service d'Hématologie, Hématologie Clinique, CHU, Toulouse, France
| | - Jérôme Cornillon
- Service d'Hématologie, Hematology, Institut de Cancérologie de la Loire, Loire, France
| | | | - Faezeh Legrand
- Service d'Hématologie, Hematology, CHU Besançon, Besancon, France
| | | | - Gérard Michel
- Department of Hematology, Hôpital La Timone, Marseille, France
| | | | | | - Sébastien Maury
- Service d'Hématologie, Service d'Hematologie, Hôpital Henri Mondor, Creteil, France
| | - Madalina Uzunov
- Service d'Hématologie, Pitié-Salpêtrière (AP-HP), Paris, France
| | | | | | | | | | - Karin Bilger
- Service d'Hématologie, CHRU Strasbourg, Strasbourg, France
| | - Eliane Gluckman
- Service d'Hématologie, Eurocord Office, Hôpital Saint-Louis, Paris, France
| | - Annalisa Ruggeri
- Service d'Hématologie, Eurocord Office, Hôpital Saint-Louis, Paris, France; Service d'Hématologie, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
| | - Agnès Buzyn
- Service d'Hématologie, Comité Scientifique, SFGM-TC, Hôpital Necker (AP-HP), Paris, France
| | - Stéphanie Nguyen
- Service d'Hématologie, Hôpital Pitié Salpêtrière (AP-HP), Paris, France
| | - Tabassome Simon
- Service d'Hématologie, URC Est Saint Antoine (AP-HP), Paris, France
| | - Nöel Milpied
- Service d'Hématologie, Service d'Hématologie clinique et de thérapie cellulaire, CHU de Bordeaux Hopital du Haut-Lévèque, Pessac, France
| | - Vanderson Rocha
- Service d'Hématologie, Eurocord Office, Hôpital Saint-Louis, Paris, France; Department of Haematology, Churchill Hospital, Oxford, United Kingdom.
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Konuma T, Kato S, Ooi J, Oiwa-Monna M, Ebihara Y, Mochizuki S, Yuji K, Ohno N, Kawamata T, Jo N, Yokoyama K, Uchimaru K, Tojo A, Takahashi S. Effect of ABO Blood Group Incompatibility on the Outcome of Single-Unit Cord Blood Transplantation after Myeloablative Conditioning. Biol Blood Marrow Transplant 2014; 20:577-81. [DOI: 10.1016/j.bbmt.2013.12.563] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 12/18/2013] [Indexed: 11/29/2022]
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