Prospective Study of Single vs. Two Unit Umbilical Cord Blood Transplantation Following Reduced Intensity Conditioning in Adults with Hematologic Malignancies
As the threshold nucleated cell dose for single unit umbilical cord blood (UCB) in adults has not to date been firmly established, we prospectively compared single vs. 2-unit UCB transplantation after reduced intensity conditioning (RIC) in adult patients with hematologic malignancies. Study design...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2011-10, Vol.47 (7), p.924-933 |
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| creator | Kindwall-Keller, Tamila L. Hegerfeldt, Yael Meyerson, Howard J. Margevicius, Seunghee Fu, Pingfu van Heeckeren, Willem Lazarus, Hillard M. Cooper, Brenda W. Gerson, Stanton L. Barr, Paul Tse, William W. Curtis, Christine Fanning, Laura R. Creger, Richard J. Carlson-Barko, Joanne M. Laughlin, Mary J. |
| description | As the threshold nucleated cell dose for single unit umbilical cord blood (UCB) in adults has not to date been firmly established, we prospectively compared single vs. 2-unit UCB transplantation after reduced intensity conditioning (RIC) in adult patients with hematologic malignancies. Study design specified one UCB unit if the cryopreserved total nucleated cell (TNC) dose was ≥2.5×10
7
/kg recipient weight, otherwise 2-units matched at minimum 4/6 HLA loci to the patient and 3/6 to each other were infused. Twenty-seven patients received 1 unit; 23 patients received 2 units. Median time to absolute neutrophil count (ANC) >500/μL was 24 days (95% CI 22–28 days), 25 days for 1-unit and 23 days for 2-units (p=0.99). At day 100, ANC >500/μL was 88.4% and 91.3% in the 1 and 2-unit groups (p=0.99), respectively. Three-year event free survival (EFS) was 28.6% and 39.1% in the 1 and 2-unit groups (p=0.71), respectively. Infusion of 2 units was associated with significantly lower relapse risk, 30.4% vs. 59.3% (p=0.045). Infused cell doses (TNC, CD3
+
, CD34
+
, CD56
+
CD3
neg
) did not impact engraftment, overall survival (OS), or EFS. Taken together, single unit UCB transplantation with threshold cell dose ≥2.5×10
7
/kg recipient weight after RIC is a viable option for adults, although infusion of 2 units confers a lower relapse incidence. |
| doi_str_mv | 10.1038/bmt.2011.195 |
| format | Article |
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7
/kg recipient weight, otherwise 2-units matched at minimum 4/6 HLA loci to the patient and 3/6 to each other were infused. Twenty-seven patients received 1 unit; 23 patients received 2 units. Median time to absolute neutrophil count (ANC) >500/μL was 24 days (95% CI 22–28 days), 25 days for 1-unit and 23 days for 2-units (p=0.99). At day 100, ANC >500/μL was 88.4% and 91.3% in the 1 and 2-unit groups (p=0.99), respectively. Three-year event free survival (EFS) was 28.6% and 39.1% in the 1 and 2-unit groups (p=0.71), respectively. Infusion of 2 units was associated with significantly lower relapse risk, 30.4% vs. 59.3% (p=0.045). Infused cell doses (TNC, CD3
+
, CD34
+
, CD56
+
CD3
neg
) did not impact engraftment, overall survival (OS), or EFS. Taken together, single unit UCB transplantation with threshold cell dose ≥2.5×10
7
/kg recipient weight after RIC is a viable option for adults, although infusion of 2 units confers a lower relapse incidence.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/bmt.2011.195</identifier><identifier>PMID: 22002488</identifier><language>eng</language><ispartof>Bone marrow transplantation (Basingstoke), 2011-10, Vol.47 (7), p.924-933</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids></links><search><creatorcontrib>Kindwall-Keller, Tamila L.</creatorcontrib><creatorcontrib>Hegerfeldt, Yael</creatorcontrib><creatorcontrib>Meyerson, Howard J.</creatorcontrib><creatorcontrib>Margevicius, Seunghee</creatorcontrib><creatorcontrib>Fu, Pingfu</creatorcontrib><creatorcontrib>van Heeckeren, Willem</creatorcontrib><creatorcontrib>Lazarus, Hillard M.</creatorcontrib><creatorcontrib>Cooper, Brenda W.</creatorcontrib><creatorcontrib>Gerson, Stanton L.</creatorcontrib><creatorcontrib>Barr, Paul</creatorcontrib><creatorcontrib>Tse, William W.</creatorcontrib><creatorcontrib>Curtis, Christine</creatorcontrib><creatorcontrib>Fanning, Laura R.</creatorcontrib><creatorcontrib>Creger, Richard J.</creatorcontrib><creatorcontrib>Carlson-Barko, Joanne M.</creatorcontrib><creatorcontrib>Laughlin, Mary J.</creatorcontrib><title>Prospective Study of Single vs. Two Unit Umbilical Cord Blood Transplantation Following Reduced Intensity Conditioning in Adults with Hematologic Malignancies</title><title>Bone marrow transplantation (Basingstoke)</title><description>As the threshold nucleated cell dose for single unit umbilical cord blood (UCB) in adults has not to date been firmly established, we prospectively compared single vs. 2-unit UCB transplantation after reduced intensity conditioning (RIC) in adult patients with hematologic malignancies. Study design specified one UCB unit if the cryopreserved total nucleated cell (TNC) dose was ≥2.5×10
7
/kg recipient weight, otherwise 2-units matched at minimum 4/6 HLA loci to the patient and 3/6 to each other were infused. Twenty-seven patients received 1 unit; 23 patients received 2 units. Median time to absolute neutrophil count (ANC) >500/μL was 24 days (95% CI 22–28 days), 25 days for 1-unit and 23 days for 2-units (p=0.99). At day 100, ANC >500/μL was 88.4% and 91.3% in the 1 and 2-unit groups (p=0.99), respectively. Three-year event free survival (EFS) was 28.6% and 39.1% in the 1 and 2-unit groups (p=0.71), respectively. Infusion of 2 units was associated with significantly lower relapse risk, 30.4% vs. 59.3% (p=0.045). Infused cell doses (TNC, CD3
+
, CD34
+
, CD56
+
CD3
neg
) did not impact engraftment, overall survival (OS), or EFS. Taken together, single unit UCB transplantation with threshold cell dose ≥2.5×10
7
/kg recipient weight after RIC is a viable option for adults, although infusion of 2 units confers a lower relapse incidence.</description><issn>0268-3369</issn><issn>1476-5365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqljMtOwzAQRS0EouWx4wPmBxps50G6QYKKqiyQEG3XkRu76SBnJoqdVv0ZvhUqsWHN6i7OPUeIOyUTJdPyftPGREulEjXNz8RYZQ_FJE-L_FyMpS7KSZoW05G4CuFTSpVlMr8UI62l1FlZjsXXe8-hc3XEvYNlHOwReAtLpMY72IcEVgeGNWGEdbtBj7XxMOPewrNntrDqDYXOG4omIhPM2Xs-_Njw4exQOwuvFB0FjMcfjSyeXieMBE928DHAAeMOFq41kT03WMOb8diQoRpduBEXW-ODu_3da_E4f1nNFpNu2LTO1o5ib3zV9dia_lixweovIdxVDe-rVBdayTL9d-AbsLV7BQ</recordid><startdate>20111017</startdate><enddate>20111017</enddate><creator>Kindwall-Keller, Tamila L.</creator><creator>Hegerfeldt, Yael</creator><creator>Meyerson, Howard J.</creator><creator>Margevicius, Seunghee</creator><creator>Fu, Pingfu</creator><creator>van Heeckeren, Willem</creator><creator>Lazarus, Hillard M.</creator><creator>Cooper, Brenda W.</creator><creator>Gerson, Stanton L.</creator><creator>Barr, Paul</creator><creator>Tse, William W.</creator><creator>Curtis, Christine</creator><creator>Fanning, Laura R.</creator><creator>Creger, Richard J.</creator><creator>Carlson-Barko, Joanne M.</creator><creator>Laughlin, Mary J.</creator><scope>5PM</scope></search><sort><creationdate>20111017</creationdate><title>Prospective Study of Single vs. Two Unit Umbilical Cord Blood Transplantation Following Reduced Intensity Conditioning in Adults with Hematologic Malignancies</title><author>Kindwall-Keller, Tamila L. ; Hegerfeldt, Yael ; Meyerson, Howard J. ; Margevicius, Seunghee ; Fu, Pingfu ; van Heeckeren, Willem ; Lazarus, Hillard M. ; Cooper, Brenda W. ; Gerson, Stanton L. ; Barr, Paul ; Tse, William W. ; Curtis, Christine ; Fanning, Laura R. ; Creger, Richard J. ; Carlson-Barko, Joanne M. ; Laughlin, Mary J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-pubmedcentral_primary_oai_pubmedcentral_nih_gov_32621083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kindwall-Keller, Tamila L.</creatorcontrib><creatorcontrib>Hegerfeldt, Yael</creatorcontrib><creatorcontrib>Meyerson, Howard J.</creatorcontrib><creatorcontrib>Margevicius, Seunghee</creatorcontrib><creatorcontrib>Fu, Pingfu</creatorcontrib><creatorcontrib>van Heeckeren, Willem</creatorcontrib><creatorcontrib>Lazarus, Hillard M.</creatorcontrib><creatorcontrib>Cooper, Brenda W.</creatorcontrib><creatorcontrib>Gerson, Stanton L.</creatorcontrib><creatorcontrib>Barr, Paul</creatorcontrib><creatorcontrib>Tse, William W.</creatorcontrib><creatorcontrib>Curtis, Christine</creatorcontrib><creatorcontrib>Fanning, Laura R.</creatorcontrib><creatorcontrib>Creger, Richard J.</creatorcontrib><creatorcontrib>Carlson-Barko, Joanne M.</creatorcontrib><creatorcontrib>Laughlin, Mary J.</creatorcontrib><collection>PubMed Central (Full Participant titles)</collection><jtitle>Bone marrow transplantation (Basingstoke)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kindwall-Keller, Tamila L.</au><au>Hegerfeldt, Yael</au><au>Meyerson, Howard J.</au><au>Margevicius, Seunghee</au><au>Fu, Pingfu</au><au>van Heeckeren, Willem</au><au>Lazarus, Hillard M.</au><au>Cooper, Brenda W.</au><au>Gerson, Stanton L.</au><au>Barr, Paul</au><au>Tse, William W.</au><au>Curtis, Christine</au><au>Fanning, Laura R.</au><au>Creger, Richard J.</au><au>Carlson-Barko, Joanne M.</au><au>Laughlin, Mary J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective Study of Single vs. Two Unit Umbilical Cord Blood Transplantation Following Reduced Intensity Conditioning in Adults with Hematologic Malignancies</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><date>2011-10-17</date><risdate>2011</risdate><volume>47</volume><issue>7</issue><spage>924</spage><epage>933</epage><pages>924-933</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><abstract>As the threshold nucleated cell dose for single unit umbilical cord blood (UCB) in adults has not to date been firmly established, we prospectively compared single vs. 2-unit UCB transplantation after reduced intensity conditioning (RIC) in adult patients with hematologic malignancies. Study design specified one UCB unit if the cryopreserved total nucleated cell (TNC) dose was ≥2.5×10
7
/kg recipient weight, otherwise 2-units matched at minimum 4/6 HLA loci to the patient and 3/6 to each other were infused. Twenty-seven patients received 1 unit; 23 patients received 2 units. Median time to absolute neutrophil count (ANC) >500/μL was 24 days (95% CI 22–28 days), 25 days for 1-unit and 23 days for 2-units (p=0.99). At day 100, ANC >500/μL was 88.4% and 91.3% in the 1 and 2-unit groups (p=0.99), respectively. Three-year event free survival (EFS) was 28.6% and 39.1% in the 1 and 2-unit groups (p=0.71), respectively. Infusion of 2 units was associated with significantly lower relapse risk, 30.4% vs. 59.3% (p=0.045). Infused cell doses (TNC, CD3
+
, CD34
+
, CD56
+
CD3
neg
) did not impact engraftment, overall survival (OS), or EFS. Taken together, single unit UCB transplantation with threshold cell dose ≥2.5×10
7
/kg recipient weight after RIC is a viable option for adults, although infusion of 2 units confers a lower relapse incidence.</abstract><pmid>22002488</pmid><doi>10.1038/bmt.2011.195</doi><oa>free_for_read</oa></addata></record> |
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| source | SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Nature Journals Online |
| title | Prospective Study of Single vs. Two Unit Umbilical Cord Blood Transplantation Following Reduced Intensity Conditioning in Adults with Hematologic Malignancies |
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