Myeloablative Cord Blood Transplantation in Adults with Acute Leukemia: Comparison of Two Different Transplant Platforms

Jaime Sanz, John E. Wagner, Miguel A. Sanz, Todd DeFor, Pau Montesinos, Veronika Bachanova, Ignacio Lorenzo, Erica Warlick, Guillermo F. Sanz, Claudio Brunstein

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

We compared the clinical outcomes of adults with acute leukemia that received single-unit umbilical cord blood transplantation (sUCBT) after conditioning with a busulfan/antithymocyte globulin (BU-ATG)-based regimen at University Hospital La Fe (n= 102) or double-unit UCBT (dUCBT) after conditioning with a total body irradiation (TBI)-based regimen at the University of Minnesota (n= 91). Nonrelapse mortality, relapse and disease-free survival were similar in the 2 groups. Multivariate analyses, showed more rapid neutrophil (hazard ratio [HR], .6; 95% confidence interval [CI], .45 to .80; P= .0006) and platelet recovery (HR, .59; 95% CI, .43 to.83; P= .002) after the BU-ATG-based conditioning and sUCBT. Although there was a lower risk of acute graft-versus-host disease (GVHD) grade II to IV (HR, 2.81; 95% CI, 1.75 to 4.35; P < .001) after BU-ATG and sUCBT, the incidences of grade III to IV acute and chronic GVHD were similar between the 2 groups. Regarding disease-specific outcomes, disease-free survival in both acute myeloid leukemia and acute lymphoblastic leukemia (ALL) patients were not significantly different; however, a significantly lower relapse rate was found in patients with ALL treated with TBI and dUCBT (HR, .3; 95% CI, .12 to .84; P= .02). In the context of these specific treatment platforms, our study demonstrates that sUCB and dUCBT offer similar outcomes.

Original languageEnglish (US)
Pages (from-to)1725-1730
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number12
DOIs
StatePublished - Dec 2013

Keywords

  • Acute leukemia
  • UCB transplantation

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