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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Veröffentlicht in:Blood 2010-09, Vol.116 (11), p.1849-1856
Hauptverfasser: 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
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container_end_page 1856
container_issue 11
container_start_page 1849
container_title Blood
container_volume 116
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
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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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