Portal de investigación
Cohort-Controlled Comparison of Umbilical Cord Blood Transplantation Using Carlecortemcel-L, a Single Progenitor-Enriched Cord Blood, to Double Cord Blood Unit Transplantation
Fecha de publicación:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Stiff, PJ
- Peled, T
- Landau, E
- Goudsmid, NR
- Mandel, J
- Hasson, N
- Olesinski, E
- Glukhman, E
- Snyder, DA
- Cohen, EG
- Kidron, OS
- Bracha, D
- Harati, D
- Ben-Abu, K
- Freind, E
- Freedman, LS
- Cohen, YC
- Olmer, L
- Barishev, R
- Rocha, V
- Gluckman, E
- Horowitz, MM
- Eapen, M
- Nagler, A
Grupos
Abstract
Umbilical cord blood (UCB) transplantation has a high early mortality rate primarily related to transplanted stem cell dose. To decrease early mortality and enhance engraftment, a portion of selected cord blood units (20% to 50%) was expanded with cytokines and the copper chelator tetraethylenepentamine (carlecortemcel-L) and transplanted with the unmanipulated fraction after myeloablative conditioning. The primary endpoint was 100-day survival, which was compared with a contemporaneous double-unit cord blood transplantation (DUCBT) group. We enrolled 101 patients at 25 sites; the DUCBT comparison (n = 295) was selected from international registries using study eligibility criteria. Baseline carlecortemcel-L study group unit nucleated cell (NC) and CD34(+) were 3.06 x 10(7) cell dose/kg and 1.64 x 10(5) cell dose/kg. Median NC and CD34(+) fold expansion were 400 and 77, with a mean total CD34 infused of 9.7 x 10(5)/kg. The 100-day survival was 84.2% for the carlecortemcel-L study group versus 74.6% for the DUCBT group (odds ratio, .50; 95% Cl, .26 to .95; P= .035). Survival at day 180 was similar for the 2 groups; the major cause of death after day 100 was opportunistic infections. Faster median neutrophil (21 days versus 28 days; P <.0001), and platelet (54 days versus 105 days; P = .008) engraftment was seen in the carlecortemcel-L study group; acute and chronic graft-versus-host disease rates were similar. In this multinational comparative study, transplanting expanded CD34(+) stem cells from a portion of a single UCB unit, with the remaining unmanipulated fraction improved 100-day survival compared with DUCBT control patients while facilitating myeloid and platelet engraftment. (C) 2018 American Society for Blood and Marrow Transplantation.
Datos de la publicación
- ISSN/ISSNe:
- 1083-8791, 1523-6536
- Tipo:
- Article
- Páginas:
- 1463-1470
- PubMed:
- 29477778
- Factor de Impacto:
- 2,087 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION ELSEVIER SCIENCE INC
Citas Recibidas en Web of Science: 34
Documentos
- No hay documentos
Filiaciones
Keywords
- Ex vivo; Umbilical cord blood; Transplantation
Cita
Stiff PJ,MONTESINOS P,Peled T,Landau E,Goudsmid NR,Mandel J,Hasson N,Olesinski E,Glukhman E,Snyder DA,Cohen EG,Kidron OS,Bracha D,Harati D,Ben K,Freind E,Freedman LS,Cohen YC,Olmer L,Barishev R,Rocha V,Gluckman E,Horowitz MM,Eapen M,Nagler A,SANZ G. Cohort-Controlled Comparison of Umbilical Cord Blood Transplantation Using Carlecortemcel-L, a Single Progenitor-Enriched Cord Blood, to Double Cord Blood Unit Transplantation. Biol. Blood Marrow Transplant. 2018. 24. (7):p. 1463-1470. IF:3,599. (2).