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
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
- Tipo:
- Article
- Páginas:
- 887-894
- DOI:
- 10.1038/bmt.2014.72
- PubMed:
- 24986801
- Factor de Impacto:
- 1,534 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
BONE MARROW TRANSPLANTATION SPRINGERNATURE
Citas Recibidas en Web of Science: 15
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