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  3. Reduced-Intensity versus Myeloablative Conditioning in Cord Blood Transplantation for Acute Myeloid Leukemia (40-60 years) across Highly Mismatched HLA Barriers-On Behalf of Eurocord and the Cellular Therapy & Immunobiology Working Party (CTIWP) of EBMT.

Reduced-Intensity versus Myeloablative Conditioning in Cord Blood Transplantation for Acute Myeloid Leukemia (40-60 years) across Highly Mismatched HLA Barriers-On Behalf of Eurocord and the Cellular Therapy & Immunobiology Working Party (CTIWP) of EBMT.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Sheth V
  • Volt F
  • Clement L
  • Cornelissen J
  • Blaise D
  • Sierra J
  • Michallet M
  • Saccardi R
  • Rocha V
  • Gluckman E
  • Chabannon C
  • Ruggeri A

Grupos

Abstract

The use of myeloablative conditioning (MAC) in umbilical cord blood transplantation (UCBT) has been associated with high nonrelapse mortality (NRM) in patients aged >40 years, especially those having a high HLA disparity, thus limiting wider applications. We hypothesized that the NRM advantage of reduced-intensity conditioning (RIC) and higher graft-versus-leukemia effect associated with greater HLA disparities would expand its use for patients (aged 40 to 60 years) without compromising efficacy and compared outcomes between RIC and MAC regimens. In total, 288 patients aged 40 to 60 years, with de novo acute myeloid leukemia, receiving UCBT with at least 2 HLA mismatches with RIC (n = 166) or MAC (n = 122) regimens were included. As compared to RIC, the MAC cohort included relatively younger patients, having received more single UCBT, with lower total nucleated cell counts and more in vivo T cell depletion. Median time to neutrophil engraftment, infections (bacterial, viral, and fungal), and grade II to IV acute and chronic graft-versus-host disease were similar in both groups. In the multivariate analysis, overall survival (hazard ratio [HR], 0.98; P = .9), NRM (HR, 0.68; P = .2), and relapse (HR, 1.24; P = .5) were not different between RIC and MAC. Refractory disease was associated with worse survival. Outcomes of UBCT for patients aged 40 to 60 years having =2 HLA mismatches are comparable after the RIC or MAC regimen.

Datos de la publicación

ISSN/ISSNe:
1083-8791, 1523-6536

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION  ELSEVIER SCIENCE INC

Tipo:
Article
Páginas:
2098-2104
PubMed:
32726672
Factor de Impacto:
2,301 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 8

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Keywords

  • Mismatched, Myeloablative, Reduced intensity, Umbilical cord transplant

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