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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

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: 01/07/2014

Autores de IIS La Fe

Guillermo Sanz Santillana

Autor
Pascual Sanz Bigorra

Autor
Pau Montesinos Fernández

Autor

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

Hematología y Hemoterapia

Investigador Principal

Javier De La Rubia Comos

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
Tipo:: Article
Páginas:: 887-894
DOI:: 10.1038/bmt.2014.72
Factor de Impacto:: 1,534 SCImago ℠
Cuartil:: Q1 SCImago ℠

Documentos

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Métricas

Filiaciones

Tucunduva L:: 1] Eurocord AP-HP, University Paris-Diderot, Saint-Louis Hospital , Paris, France [2] Centro de Oncologia, Hospital Sirio Libanes, Sao Paulo, Brazil
Ruggeri A:: 1] Eurocord AP-HP, University Paris-Diderot, Saint-Louis Hospital , Paris, France [2] Rome Transplant Network, University Tor Vergata, Rome, Italy
Sanz G:: Servicio de Hematología, Hospital Universitario La Fe, Valencia, Spain
Furst S:: Department of Hematology, Institut Paoli Calmettes, Marseille, France
Socié G:: Department of Hematology, Bone Marrow Transplantation Unit, Saint-Louis Hospital, Paris, France
Michallet M:: Department of Hematology, Edouard Herriot Hospital, Lyon, France
Arcese W:: Division of Hematology, Stem Cell Transplant Unit, University of Rome Tor Vergata, Rome, Italy
Milpied N:: Department of Hematology, CHU Bordeaux, Hôpital Haut-leveque, Pessac, France
Yakoub-Agha I:: Division of Hematology, CHU de Lille, Lille, France
Linkesch W:: Division of Hematology, Medical University Graz, Graz, Austria
Cornelissen J:: Department of Hematology, Erasmus MC/Daniel Den Hoed, Rotterdam, Netherlands
Mannone L:: Service d'hématologie clinique, Hôpital de l'ARCHET, Nice, France
Iori AP:: Department of Cell Biotechnology and Hematology, University La Sapienza, Rome, Italy
Ribera JM:: Department of Hematology, ICO-Hospital Universitari Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Spain
Sanz J:: Servicio de Hematología, Hospital Universitario La Fe, Valencia, Spain
Montesinos P:: Servicio de Hematología, Hospital Universitario La Fe, Valencia, Spain
Purtill D:: Eurocord AP-HP, University Paris-Diderot, Saint-Louis Hospital , Paris, France
Labopin M:: Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC Université Paris 6, UMR-S 938, CEREST-TC EBMT, Hôpital Saint Antoine, Paris, France
Gluckman E:: Eurocord AP-HP, University Paris-Diderot, Saint-Louis Hospital , Paris, France
Mohty M:: Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC Université Paris 6, UMR-S 938, CEREST-TC EBMT, Hôpital Saint Antoine, Paris, France
Rocha V:: 1] Eurocord AP-HP, University Paris-Diderot, Saint-Louis Hospital , Paris, France [2] Centro de Oncologia, Hospital Sirio Libanes, Sao Paulo, Brazil [3] Department of Hematology, Churchill Hospital, Oxford University Hospitals, Oxford, UK

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

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