Risk factors for outcomes after unrelated cord blood transplantation for adults with acute lymphoblastic leukemia: a report on behalf of Eurocord and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Tucunduva L
  • Ruggeri A
  • Furst S
  • Socié G
  • Michallet M
  • Arcese W
  • Milpied N
  • Yakoub-Agha I
  • Linkesch W
  • Cornelissen J
  • Mannone L
  • Iori AP
  • Ribera JM
  • Purtill D
  • Labopin M
  • Gluckman E
  • Mohty M
  • Rocha V

Grupos

Abstract

We performed a retrospective analysis on 421 adult patients who underwent unrelated cord blood transplantation (UCBT) for ALL. Median age was 32 years; 46% were in first CR (CR1), 32% in CR2 and 22% had advanced disease. Double UCBT was performed in 173 patients (41%). Myeloablative conditioning (MAC) was given to 314 patients (75%). Cumulative incidence (CI) of 60-day neutrophil recovery was 78%. CI of acute and chronic GVHD was 33 and 26%, respectively. Non-relapse mortality (NRM) at 2 years was 42%. Age >= 35 years (P < 0.0001), advanced disease at UCBT (P < 0.0001) and use of MAC (P < 0.0001) were associated with increased NRM. Relapse incidence (RI) at 2 years was 28%; use of reduced intensity conditioning (RIC) (P = 0.0002) was associated with increased RI. Two-year leukemia-free survival (LFS) was 39% for patients in CR1, 31% for CR2 and 8% for advanced disease. In multivariate analysis, factors associated with decreased LFS rate were: age >= 35 years (P = 0.034), use of MAC (P = 0.032) and advanced disease (P < 0.0001). These results show that UCBT is a valuable option to treat high-risk adult ALL when in remission. Strategies to decrease toxicity and relapse are needed to improve final outcomes.

Datos de la publicación

ISSN/ISSNe:
0268-3369, 1476-5365

BONE MARROW TRANSPLANTATION  SPRINGERNATURE

Tipo:
Article
Páginas:
887-894
PubMed:
24986801
Factor de Impacto:
1,534 SCImago
Cuartil:
Q1 SCImago

Citas Recibidas en Web of Science: 15

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