TY - JOUR
T1 - Analysis of risk factors for outcomes after unrelated cord blood transplantation in adults with lymphoid malignancies
T2 - A study by the Eurocord-Netcord and Lymphoma Working Party of the European Group for blood and marrow transplantation
AU - Rodrigues, Celso A.
AU - Sanz, Guillermo
AU - Brunstein, Claudio G.
AU - Sanz, Jaime
AU - Wagner, John E.
AU - Renaud, Marc
AU - De Lima, Marcos
AU - Cairo, Mitchell S.
AU - Fürst, Sabine
AU - Rio, Bernard
AU - Dalley, Christopher
AU - Carreras, Enric
AU - Harousseau, Jean Luc
AU - Mohty, Mohamad
AU - Taveira, Denis
AU - Dreger, Peter
AU - Sureda, Anna
AU - Gluckman, Eliane
AU - Rocha, Vanderson
PY - 2009/1/10
Y1 - 2009/1/10
N2 - Purpose: To determine risk factors of umbilical cord blood transplantation (UCBT) for patients with lymphoid malignancies. Patients and Methods: We evaluated 104 adult patients (median age, 41 years) who underwent unrelated donor UCBT for lymphoid malignancies. UCB grafts were two-antigen human leukocyte antigen-mismatched in 68%, and were composed of one (n = 78) or two (n = 26) units. Diagnoses were non-Hodgkin's lymphoma (NHL, n = 61), Hodgkin's lymphoma (HL, n = 29), and chronic lymphocytic leukemia (CLL, n = 14), with 87% having advanced disease and 60% having experienced failure with a prior autologous transplant. Sixty-four percent of patients received a reduced-intensity conditioning regimen and 46% low-dose total-body irradiation (TBI). Median follow-up was 18 months. Results: Cumulative incidence of neutrophil engraftment was 84% by day 60, with greater engraftment in recipients of higher CD34+ kg/cell dose (P = .0004). CI of non-relapse-related mortality (NRM) was 28% at 1 year, with a lower risk in patients treated with low-dose total-body irradiation (TBI; P = .03). Cumulative incidence of relapse or progression was 31% at 1 year, with a lower risk in recipients of double-unit UCBT (P = .03). The probability of progression-free survival (PFS) was 40% at 1 year, with improved survival in those with chemosensitive disease (49% v 34%; P = .03), who received conditioning regimens containing low-dose TBI (60% v 23%; P = .001), and higher nucleated cell dose (49% v 21%; P = .009). Conclusion: UCBT is a viable treatment for adults with advanced lymphoid malignancies. Chemosensitive disease, use of low-dose TBI, and higher cell dose were factors associated with significantly better outcome.
AB - Purpose: To determine risk factors of umbilical cord blood transplantation (UCBT) for patients with lymphoid malignancies. Patients and Methods: We evaluated 104 adult patients (median age, 41 years) who underwent unrelated donor UCBT for lymphoid malignancies. UCB grafts were two-antigen human leukocyte antigen-mismatched in 68%, and were composed of one (n = 78) or two (n = 26) units. Diagnoses were non-Hodgkin's lymphoma (NHL, n = 61), Hodgkin's lymphoma (HL, n = 29), and chronic lymphocytic leukemia (CLL, n = 14), with 87% having advanced disease and 60% having experienced failure with a prior autologous transplant. Sixty-four percent of patients received a reduced-intensity conditioning regimen and 46% low-dose total-body irradiation (TBI). Median follow-up was 18 months. Results: Cumulative incidence of neutrophil engraftment was 84% by day 60, with greater engraftment in recipients of higher CD34+ kg/cell dose (P = .0004). CI of non-relapse-related mortality (NRM) was 28% at 1 year, with a lower risk in patients treated with low-dose total-body irradiation (TBI; P = .03). Cumulative incidence of relapse or progression was 31% at 1 year, with a lower risk in recipients of double-unit UCBT (P = .03). The probability of progression-free survival (PFS) was 40% at 1 year, with improved survival in those with chemosensitive disease (49% v 34%; P = .03), who received conditioning regimens containing low-dose TBI (60% v 23%; P = .001), and higher nucleated cell dose (49% v 21%; P = .009). Conclusion: UCBT is a viable treatment for adults with advanced lymphoid malignancies. Chemosensitive disease, use of low-dose TBI, and higher cell dose were factors associated with significantly better outcome.
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U2 - 10.1200/JCO.2007.15.8865
DO - 10.1200/JCO.2007.15.8865
M3 - Article
C2 - 19064984
AN - SCOPUS:58249087696
SN - 0732-183X
VL - 27
SP - 256
EP - 263
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 2
ER -