Umbilical cord blood transplantation in adults with advanced hodgkin's disease: high incidence of post-transplant lymphoproliferative disease

Fecha de publicación: 01/02/2016

Autores de IIS La Fe

Jaime Sanz Caballer

Autor
Pau Montesinos Fernández

Autor
Federico Moscardo Garcia

Autor
Miguel Ángel Sanz Alonso

Autor
Guillermo Sanz Santillana

Autor

Participantes ajenos a IIS La Fe

Piñana JL
Esquirol A
Martino R
Picardi A
Barba P
Parody R
Gayoso J
Guidi S
Terol MJ
Solano C
Arcese W
Sierra J
GETH GITMO groups

Grupos

Hematología y Hemoterapia

Investigador Principal

Javier De La Rubia Comos

Abstract

We report the outcome of 30 consecutive patients with Hodgkin disease (HD) who underwent single-unit UCBT. Most (90%) patients had failed previous autologous hematopoietic stem cell transplantation. The conditioning regimens were based on combinations of thiotepa, busulfan, cyclophosphamide or fludarabine, and antithymocyte globulin. The cumulative incidence (CI) of myeloid engraftment was 90% [95% confidence interval (C.I.), 74-98%] with a median of 18 d (range, 10-48). CI of acute graft-versus-host disease (GvHD) grades II-IV was 30% (95% C.I., 17-44%), while the incidence of chronic GVHD was 42% (95% C.I., 23-77%). The non-relapse mortality (NRM) at 100 d and 4 yr was 30% (95% C.I., 13-46%) and 47% (95% C.I., 29-65%), respectively. EBV-related post-transplant lymphoproliferative disease (EBV-PTLD) accounted for more than one-third of transplant-related death, with an estimate incidence of 26% (95% C.I., 9-44). The incidence of relapse at 4 yr was 25% (95% C.I., 9-42%). Four-year event-free survival (EFS) and overall survival (OS) were 28% and 30%, respectively. Despite a high NRM and an unexpected high incidence of EBV-PTLD, UCBT in heavily pretreated HD patients is an option for patients lacking a suitable adult donor, provided the disease is not in refractory relapse.

Datos de la publicación

ISSN/ISSNe:: 0902-4441, 1600-0609
Tipo:: Article
Páginas:: 128-135
DOI:: 10.1111/ejh.12557
Factor de Impacto:: 1,010 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Piñana JL:: Department of Hematology, Hospital Clínico Universitario, Fundación INCLIVA, Valencia, Spain
Sanz J:: Department of Hematology, Hospital Universitario La Fe, Valencia, Spain
Esquirol A:: Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Martino R:: Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Picardi A:: Rome Transplant Network, UOC Trapianto di Cellule Staminali, Università di Roma Tor Vergata, Rome, Italy
Barba P:: Department of Hematology, Hospital Universitari Vall D'Hebron, Barcelona, Spain
Parody R:: Department of Clinical Hematology, Hospital Virgen del Rocio, Sevilla, Spain
Gayoso J:: Department of Hematology, Hospital Gregorio Marañon, Madrid, Spain
Montesinos P:: Department of Hematology, Hospital Universitario La Fe, Valencia, Spain
Guidi S:: Bone Marrow Transplant Unit, Department of Hematology, AOU Careggi, Florence, Italy
Terol MJ:: Department of Hematology, Hospital Clínico Universitario, Fundación INCLIVA, Valencia, Spain
Moscardó F:: Department of Hematology, Hospital Universitario La Fe, Valencia, Spain
Solano C:: Department of Hematology, Hospital Clínico Universitario, Fundación INCLIVA, Valencia, Spain
Arcese W:: Rome Transplant Network, UOC Trapianto di Cellule Staminali, Università di Roma Tor Vergata, Rome, Italy
Sanz MA:: Department of Hematology, Hospital Universitario La Fe, Valencia, Spain

Medicine Department, Universitat de Valencia, Valencia, Spain
Sierra J:: Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Hospital de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Leukemia Research Institute, Universidad Autónoma de Barcelona, Barcelona, Spain
Sanz G:: Department of Hematology, Hospital Universitario La Fe, Valencia, Spain

Keywords

Hodgkin's disease; umbilical cord blood transplantation; Hodgkin's lymphoma; EBV post-transplant lymphoproliferative disease

Campos de estudio

Proyectos asociados

RED DE INVESTIGACION COOPERATIVA DE CANCER

RD06/0020/0031 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006

PROYECTO CAIBER

CAI08/01/0061 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2009

CREACION Y MEJORA DE INFRAESTRUCTURAS EN MEDICINA REGENERATIVA

Investigador Principal: FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA

PLE2009-0141 ACI-PLAN E . MINISTERIO DE CIENCIA E INNOVACION; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2009