التفاصيل البيبلوغرافية
| العنوان: |
Single-Unit Umbilical Cord Blood Transplantation from Unrelated Donors in Adult Patients with Chronic Myelogenous Leukemia |
| المؤلفون: |
Sanz, Jaime1,2 sanz_jai@gva.es, Montesinos, Pau1, Saavedra, Silvana1, Lorenzo, Ignacio1, Senent, Leonor1, Planelles, Dolores3, Larrea, Luis3, Martín, Guillermo1, Palau, Javier1, Jarque, Isidro1, Martínez, Jesús1, de la Rubia, Javier1, Moscardó, Federico1, Martinez, David1, Gómez, Inés1, López, María1, Sanz, Miguel A.1, Sanz, Guillermo F.1 |
| المصدر: |
Biology of Blood & Marrow Transplantation. Nov2010, Vol. 16 Issue 11, p1589-1595. 7p. |
| مصطلحات موضوعية: |
*CORD blood, *CHRONIC myeloid leukemia, *BLOOD transfusion, *STEM cell transplantation, *HEALTH outcome assessment, *GRAFT versus host disease, *MEDICAL statistics, *PATIENTS |
| مستخلص: |
Clinical studies focused on outcomes of umbilical cord blood transplantation (UCBT) for patients with chronic myelogenous leukemia (CML) in need of allogeneic stem cell transplantation and lacking an HLA-matched adult donor are limited. We analyzed the outcome of 26 adults with CML receiving single-unit UCBT from unrelated donors after myeloablative conditioning at a single institution. Conditioning regimens were based on combinations of thiotepa, busulfan, cyclophospamide or fludarabine, and antithymocyte globulin. At the time of transplantation, 7 patients (27%) were in first chronic phase (CP), 11 (42%) were in second CP, 2 (8%) were in accelerated phase (AP), and 6 (23%) were in blast crisis (BC). The cumulative incidence (CI) of myeloid engraftment was 88% at a median time of 22 days and was significantly better for patients receiving higher doses of CD34+ cells. The CI of acute graft-versus-host disease (GVHD) grade II-IV was 61%, that of acute GVHD grade III-IV was 39%, and that of chronic extensive GVHD was 60%. Treatment-related mortality (TRM) was 41% for patients undergoing UCBT while in first or second CP and 100% for patients in AP or BC (P < .01). After a median follow-up of 8 years, none of the patients relapsed, giving an overall disease-free survival (DFS) at 8 years of 41%. The DFS for patients undergoing UCBT while in any CP was 59%. These results demonstrate that UCBT from unrelated donors can be a curative treatment for a substantial number of patients with CML. Advances in supportive care and better selection of cord blood units and patients are needed to improve TRM. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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