Umbilical cord blood transplantation from unrelated donors in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia

Fecha de publicación: 01/02/2014

Autores de IIS La Fe

Amparo Verdeguer Miralles

Autor
Pau Montesinos Fernández

Autor
Miguel Ángel Sanz Alonso

Autor
Guillermo Sanz Santillana

Autor

Participantes ajenos a IIS La Fe

Piñana JL
Sanz J
Picardi A
Ferrá C
Martino R
Barba P
Gonzalez-Vicent M
Pascual MJ
Martín C
de Heredia CD
Ribera JM
Arcese W
GETH groups
GITMO groups

Grupos

Hematología y Hemoterapia

Investigador Principal

Javier De La Rubia Comos
Investigación Clínica y Traslacional en Cáncer

Leader

José Gómez Codina

Abstract

There are very few disease-specific studies focusing on outcomes of umbilical cord blood transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. We report the outcome of 45 patients with Philadelphia chromosome-positive acute lymphoblastic leukemia who underwent myeloablative single unit cord blood transplantation from unrelated donors within the GETH/GITMO cooperative group. Conditioning regimens were based on combinations of thiotepa, busulfan, cyclophospamide or fludarabine, and antithymocyte globulin. At the time of transplantation, 35 patients (78%) were in first complete remission, four (8%) in second complete remission and six (14%) in third or subsequent response. The cumulative incidence of myeloid engraftment was 96% at a median time of 20 days and significantly better for patients receiving higher doses of CD34(+) cells. The incidence of acute grade II-IV graft-versus-host disease was 31%, while that of overall chronic graft-versus-host disease was 53%. Treatment-related mortality was 17% at day +100 and 31% at 5 years. The 5-year relapse, event-free survival and overall survival rates were 31%, 36% and 44%, respectively. Although the event-free and overall survival rates in patients without BCR/ABL transcripts detectable at time of transplant were better than those in whom BCR/ABL transcripts were detected (46% versus 24% and 60% versus 30%, respectively) these differences were not statistically significant in the univariate analysis (P=0.07). These results demonstrate that umbilical cord blood transplantation from unrelated donors can be a curative treatment for a substantial number of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia.

Datos de la publicación

ISSN/ISSNe:: 0390-6078, 1592-8721
Tipo:: Article
Páginas:: 378-384
DOI:: 10.3324/haematol.2013.091009
Factor de Impacto:: 2,617 SCImago ℠
Cuartil:: Q1 SCImago ℠

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PROYECTO CAIBER

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