TY - JOUR
T1 - Myeloablative Cord Blood Transplantation in Adults with Acute Leukemia
T2 - Comparison of Two Different Transplant Platforms
AU - Sanz, Jaime
AU - Wagner, John E.
AU - Sanz, Miguel A.
AU - DeFor, Todd
AU - Montesinos, Pau
AU - Bachanova, Veronika
AU - Lorenzo, Ignacio
AU - Warlick, Erica
AU - Sanz, Guillermo F.
AU - Brunstein, Claudio
PY - 2013/12
Y1 - 2013/12
N2 - 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.
AB - 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.
KW - Acute leukemia
KW - UCB transplantation
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UR - http://www.scopus.com/inward/citedby.url?scp=84887533484&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2013.09.015
DO - 10.1016/j.bbmt.2013.09.015
M3 - Article
C2 - 24090598
AN - SCOPUS:84887533484
SN - 1083-8791
VL - 19
SP - 1725
EP - 1730
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 12
ER -
