Long-term follow-up and factors influencing outcomes after related HLA-identical cord blood transplantation for patients with malignancies: an analysis on behalf of Eurocord-EBMT
We analyzed risk factors influencing outcomes after related (R) human leukocyte antigen-identical cord blood transplantation (CBT) for 147 patients with malignancies reported to Eurocord–European Group for Blood and Marrow Transplantation. CBT has been performed since 1990; median follow-up was 6.7...
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creator | Herr, Andrée-Laure Kabbara, Nabil Bonfim, Carmem M.S. Teira, Pierre Locatelli, Franco Tiedemann, Karin Lankester, Arjan Jouet, Jean-Pierre Messina, Chiara Bertrand, Yves Díaz de Heredia, Cristina Peters, Christina Chaves, Wagnara Nabhan, Samir K. Ionescu, Irina Gluckman, Eliane Rocha, Vanderson |
description | We analyzed risk factors influencing outcomes after related (R) human leukocyte antigen-identical cord blood transplantation (CBT) for 147 patients with malignancies reported to Eurocord–European Group for Blood and Marrow Transplantation. CBT has been performed since 1990; median follow-up was 6.7 years. Median patient age was 5 years. Acute leukemia was the most frequent diagnosis (74%). At CBT, 40 patients had early, 70 intermediate, and 37 advanced disease. CB grafts contained a median of 4.1 × 107/kg total nucleated cells (TNCs) after thawing. The cumulative incidence (CI) of neutrophil recovery was 90% at day +60. CIs of acute and chronic graft-versus-host disease (GVHD) were 12% and 10% at 2 years, respectively. At 5 years, CIs of nonrelapse mortality and relapse were 9% and 47%, respectively; the probability of disease-free survival (DFS) and overall survival were 44% and 55%, respectively. Among other factors, higher TNCs infused was associated with rapid neutrophil recovery and improved DFS. The use of methotrexate as GVHD prophylaxis decreased the CI of engraftment. Patients without advanced disease had improved DFS. These results support banking and use of CB units for RCBT. Cell dose, GVHD prophylaxis not including methotrexate, and disease status are important factors for outcomes after RCBT. |
doi_str_mv | 10.1182/blood-2010-02-271692 |
format | Article |
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CBT has been performed since 1990; median follow-up was 6.7 years. Median patient age was 5 years. Acute leukemia was the most frequent diagnosis (74%). At CBT, 40 patients had early, 70 intermediate, and 37 advanced disease. CB grafts contained a median of 4.1 × 107/kg total nucleated cells (TNCs) after thawing. The cumulative incidence (CI) of neutrophil recovery was 90% at day +60. CIs of acute and chronic graft-versus-host disease (GVHD) were 12% and 10% at 2 years, respectively. At 5 years, CIs of nonrelapse mortality and relapse were 9% and 47%, respectively; the probability of disease-free survival (DFS) and overall survival were 44% and 55%, respectively. Among other factors, higher TNCs infused was associated with rapid neutrophil recovery and improved DFS. The use of methotrexate as GVHD prophylaxis decreased the CI of engraftment. Patients without advanced disease had improved DFS. These results support banking and use of CB units for RCBT. Cell dose, GVHD prophylaxis not including methotrexate, and disease status are important factors for outcomes after RCBT.</description><identifier>ISSN: 0006-4971</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2010-02-271692</identifier><identifier>PMID: 20538797</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Acute Disease ; Adolescent ; Adult ; Biological and medical sciences ; Child ; Child, Preschool ; Cord Blood Stem Cell Transplantation - adverse effects ; Cord Blood Stem Cell Transplantation - methods ; Disease-Free Survival ; Female ; Follow-Up Studies ; Graft vs Host Disease - etiology ; Graft vs Host Disease - immunology ; Hematologic and hematopoietic diseases ; Hematologic Neoplasms - immunology ; Hematologic Neoplasms - mortality ; Hematologic Neoplasms - surgery ; HLA Antigens - immunology ; Humans ; Infant ; Leukemia - immunology ; Leukemia - mortality ; Leukemia - surgery ; Leukocyte Count ; Male ; Medical sciences ; Multivariate Analysis ; Neutrophils - cytology ; Recurrence ; Risk Factors ; Survival Rate ; Time Factors ; Treatment Outcome ; Young Adult</subject><ispartof>Blood, 2010-09, Vol.116 (11), p.1849-1856</ispartof><rights>2010 American Society of Hematology</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-1785e651a674968fdff8af6d0c688f21c9af29b77f01e955a928a2857585df523</citedby><cites>FETCH-LOGICAL-c437t-1785e651a674968fdff8af6d0c688f21c9af29b77f01e955a928a2857585df523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23239178$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20538797$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Herr, Andrée-Laure</creatorcontrib><creatorcontrib>Kabbara, Nabil</creatorcontrib><creatorcontrib>Bonfim, Carmem M.S.</creatorcontrib><creatorcontrib>Teira, Pierre</creatorcontrib><creatorcontrib>Locatelli, Franco</creatorcontrib><creatorcontrib>Tiedemann, Karin</creatorcontrib><creatorcontrib>Lankester, Arjan</creatorcontrib><creatorcontrib>Jouet, Jean-Pierre</creatorcontrib><creatorcontrib>Messina, Chiara</creatorcontrib><creatorcontrib>Bertrand, Yves</creatorcontrib><creatorcontrib>Díaz de Heredia, Cristina</creatorcontrib><creatorcontrib>Peters, Christina</creatorcontrib><creatorcontrib>Chaves, Wagnara</creatorcontrib><creatorcontrib>Nabhan, Samir K.</creatorcontrib><creatorcontrib>Ionescu, Irina</creatorcontrib><creatorcontrib>Gluckman, Eliane</creatorcontrib><creatorcontrib>Rocha, Vanderson</creatorcontrib><title>Long-term follow-up and factors influencing outcomes after related HLA-identical cord blood transplantation for patients with malignancies: an analysis on behalf of Eurocord-EBMT</title><title>Blood</title><addtitle>Blood</addtitle><description>We analyzed risk factors influencing outcomes after related (R) human leukocyte antigen-identical cord blood transplantation (CBT) for 147 patients with malignancies reported to Eurocord–European Group for Blood and Marrow Transplantation. CBT has been performed since 1990; median follow-up was 6.7 years. Median patient age was 5 years. Acute leukemia was the most frequent diagnosis (74%). At CBT, 40 patients had early, 70 intermediate, and 37 advanced disease. CB grafts contained a median of 4.1 × 107/kg total nucleated cells (TNCs) after thawing. The cumulative incidence (CI) of neutrophil recovery was 90% at day +60. CIs of acute and chronic graft-versus-host disease (GVHD) were 12% and 10% at 2 years, respectively. At 5 years, CIs of nonrelapse mortality and relapse were 9% and 47%, respectively; the probability of disease-free survival (DFS) and overall survival were 44% and 55%, respectively. Among other factors, higher TNCs infused was associated with rapid neutrophil recovery and improved DFS. The use of methotrexate as GVHD prophylaxis decreased the CI of engraftment. Patients without advanced disease had improved DFS. These results support banking and use of CB units for RCBT. Cell dose, GVHD prophylaxis not including methotrexate, and disease status are important factors for outcomes after RCBT.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cord Blood Stem Cell Transplantation - adverse effects</subject><subject>Cord Blood Stem Cell Transplantation - methods</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft vs Host Disease - etiology</subject><subject>Graft vs Host Disease - immunology</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematologic Neoplasms - immunology</subject><subject>Hematologic Neoplasms - mortality</subject><subject>Hematologic Neoplasms - surgery</subject><subject>HLA Antigens - immunology</subject><subject>Humans</subject><subject>Infant</subject><subject>Leukemia - immunology</subject><subject>Leukemia - mortality</subject><subject>Leukemia - surgery</subject><subject>Leukocyte Count</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Multivariate Analysis</subject><subject>Neutrophils - cytology</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0006-4971</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1uEzEUhUcIREPhDRDyBrEy2J547GGBVKpAkYLYlLV145_UyGMPtqdVX4snxGkC7JAsXS--c3_O6bqXlLylVLJ3u5CSwYxQggnDTNBhZI-6FeVMYkIYedytCCEDXo-CnnXPSvlBCF33jD_tzhjhvRSjWHW_tinucbV5Qi6FkO7wMiOIBjnQNeWCfHRhsVH7uEdpqTpNtiBwTYGyDVCtQVfbC-yNjdVrCEinbNDDcqhmiGUOECtUn2KbkNHcvg0t6M7XGzRB8PsIrb0t79vc9iDcF19Qw3f2BoJDyaHNktOhL958_Hr9vHviIBT74lTPu--fNteXV3j77fOXy4st1uteVEyF5HbgFAaxHgfpjHMS3GCIHqR0jOoRHBt3QjhC7cg5jEwCk1xwyY3jrD_v3hz7zjn9XGypavJF29DusWkpSnBOZRMOjVwfSZ1TKdk6NWc_Qb5XlKhDWOrBD3UISxGmjmE12avTgGU3WfNX9CedBrw-AVCatS4fjCr_uJ71YzuzcR-OnG123HqbVWmGRm2Nz1ZXZZL__ya_AR0Ftj4</recordid><startdate>20100916</startdate><enddate>20100916</enddate><creator>Herr, Andrée-Laure</creator><creator>Kabbara, Nabil</creator><creator>Bonfim, Carmem M.S.</creator><creator>Teira, Pierre</creator><creator>Locatelli, Franco</creator><creator>Tiedemann, Karin</creator><creator>Lankester, Arjan</creator><creator>Jouet, Jean-Pierre</creator><creator>Messina, Chiara</creator><creator>Bertrand, Yves</creator><creator>Díaz de Heredia, Cristina</creator><creator>Peters, Christina</creator><creator>Chaves, Wagnara</creator><creator>Nabhan, Samir K.</creator><creator>Ionescu, Irina</creator><creator>Gluckman, Eliane</creator><creator>Rocha, Vanderson</creator><general>Elsevier Inc</general><general>Americain Society of Hematology</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100916</creationdate><title>Long-term follow-up and factors influencing outcomes after related HLA-identical cord blood transplantation for patients with malignancies: an analysis on behalf of Eurocord-EBMT</title><author>Herr, Andrée-Laure ; 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CBT has been performed since 1990; median follow-up was 6.7 years. Median patient age was 5 years. Acute leukemia was the most frequent diagnosis (74%). At CBT, 40 patients had early, 70 intermediate, and 37 advanced disease. CB grafts contained a median of 4.1 × 107/kg total nucleated cells (TNCs) after thawing. The cumulative incidence (CI) of neutrophil recovery was 90% at day +60. CIs of acute and chronic graft-versus-host disease (GVHD) were 12% and 10% at 2 years, respectively. At 5 years, CIs of nonrelapse mortality and relapse were 9% and 47%, respectively; the probability of disease-free survival (DFS) and overall survival were 44% and 55%, respectively. Among other factors, higher TNCs infused was associated with rapid neutrophil recovery and improved DFS. The use of methotrexate as GVHD prophylaxis decreased the CI of engraftment. Patients without advanced disease had improved DFS. These results support banking and use of CB units for RCBT. Cell dose, GVHD prophylaxis not including methotrexate, and disease status are important factors for outcomes after RCBT.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>20538797</pmid><doi>10.1182/blood-2010-02-271692</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Acute Disease Adolescent Adult Biological and medical sciences Child Child, Preschool Cord Blood Stem Cell Transplantation - adverse effects Cord Blood Stem Cell Transplantation - methods Disease-Free Survival Female Follow-Up Studies Graft vs Host Disease - etiology Graft vs Host Disease - immunology Hematologic and hematopoietic diseases Hematologic Neoplasms - immunology Hematologic Neoplasms - mortality Hematologic Neoplasms - surgery HLA Antigens - immunology Humans Infant Leukemia - immunology Leukemia - mortality Leukemia - surgery Leukocyte Count Male Medical sciences Multivariate Analysis Neutrophils - cytology Recurrence Risk Factors Survival Rate Time Factors Treatment Outcome Young Adult |
title | Long-term follow-up and factors influencing outcomes after related HLA-identical cord blood transplantation for patients with malignancies: an analysis on behalf of Eurocord-EBMT |
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