Single-unit umbilical cord blood transplantation from unrelated donors in patients with hematological malignancy using busulfan, thiotepa, fludarabine and ATG as myeloablative conditioning regimen.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8702459 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5365 (Electronic) Linking ISSN: 02683369 NLM ISO Abbreviation: Bone Marrow Transplant Subsets: MEDLINE

Publication: <2003->: London : Nature Publishing Group
Original Publication: Basingstoke, Hampshire : Scientific & Medical Division, Macmillan Press, c1986-

Cord Blood Stem Cell Transplantation*; Antilymphocyte Serum/*administration & dosage ; Hematologic Neoplasms/*therapy ; Immunosuppressive Agents/*administration & dosage ; Myeloablative Agonists/*administration & dosage ; Transplantation Conditioning/*methods; Adolescent ; Adult ; Busulfan/administration & dosage ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Graft Survival ; Hematologic Neoplasms/mortality ; Humans ; Infant ; Male ; Middle Aged ; Neoplasm Staging ; Recovery of Function ; Retrospective Studies ; Survival Rate ; Thiotepa/administration & dosage ; Unrelated Donors ; Vidarabine/administration & dosage ; Vidarabine/analogs & derivatives

Attempts to optimize outcomes in cord blood transplantation (CBT) by using new conditioning regimens and standardization of cord blood unit selection are warranted. In all, 88 patients (18 children and 70 adults) with hematological malignancy from nine Spanish institutions underwent a single-unit CBT after an i.v. BU-based myeloablative conditioning regimen. All evaluable patients except one engrafted. The overall cumulative incidence (CI) of myeloid engraftment was 94% at a median time of 19 days. In multivariate analysis, nonadvanced disease stage was the only factor with a favorable impact on myeloid engraftment. The CI of acute GVHD grades II-IV and chronic extensive GVHD were 24% each. The CI of nonrelapse mortality at 100 days, 180 days and 5 years was 14, 23 and 44%, respectively. The 5-year CI of relapse was 18%, whereas disease-free survival (DFS) was 46%, 39% and 11% for patients transplanted in early, intermediate and advanced stages of the disease, respectively. Our study shows high rates of engraftment with fast neutrophil recovery in patients undergoing single-unit CBT using a BU-based conditioning regimen. Long-term DFS can be achieved in a substantial number of patients with high-risk hematological malignancies, particularly when transplanted in an early stage of the disease.

0 (Antilymphocyte Serum)
0 (Immunosuppressive Agents)
0 (Myeloablative Agonists)
905Z5W3GKH (Thiotepa)
FA2DM6879K (Vidarabine)
G1LN9045DK (Busulfan)
P2K93U8740 (fludarabine)

Date Created: 20120214 Date Completed: 20130311 Latest Revision: 20220311

20221213

10.1038/bmt.2012.13

22327127