Single- or double-unit UCBT following RIC in adults with AL: a report from Eurocord, the ALWP and the CTIWP of the EBMTReportar como inadecuado

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* Corresponding author 1 Department of Hematology Liege, Belgium 2 Eurocord AP-HP Hôpital Saint-Louis 3 Service d-hématologie clinique et de thérapie cellulaire CHU Saint-Antoine 4 EBMT Paris Office AP-HP Hôpital Saint-Antoine 5 Service d-Hématologie Marseille 6 Erasmus Medical Center Rotterdam, The Netherlands 7 Service d-Hématologie CHU Nantes 8 Servicio de Hematologia Valencia, Spain 9 UMCU - Department of Hematology Utrecht, The Netherlands 10 Vanderbilt University Medical Center Nashville 11 France Monacord Monaco 12 IUH - Institut Universitaire d-Hématologie 13 Division of Hematology and Bone Marrow Transplantation Ramat-Gan, Israel

Abstract : AbstractBackgroundThe feasibility of cord blood transplantation CBT in adults is limited by the relatively low number of hematopoietic stem-progenitor cells contained in one single CB unit. The infusion of two CB units from different partially HLA-matched donors double CBT is frequently performed in patients who lack a sufficiently rich single CB unit.MethodsWe compared CBT outcomes in patients given single or double CBT following reduced-intensity conditioning RIC in a retrospective multicenter registry-based study. Inclusion criteria included adult ≥18 years patients, acute myeloid leukemia AML or acute lymphoblastic leukemia ALL, complete remission CR at the time of transplantation, first single with a cryopreserved TNC ≥ 2.5 × 107-kg or double CBT between 2004 and 2014, and RIC conditioning.ResultsData from 534 patients with AML n = 408 or ALL n = 126 receiving a first single n = 172 or double n = 362 CBT were included in the analyses. In univariate analysis, in comparison to patients transplanted with a single CB, double CB recipients had a similar incidence of neutrophil engraftment but a suggestion for a higher incidence of grade II–IV acute GVHD 36 versus 28%, P = 0.08. In multivariate analyses, in comparison to single CBT recipients, double CBT patients had a comparable incidence of relapse HR = 0.9, P = 0.5 and of nonrelapse mortality HR = 0.8, P = 0.3, as well as comparable overall HR = 0.8, P = 0.17, leukemia-free HR = 0.8, P = 0.2 and GVHD-free, relapse-free HR = 1.0, P = 0.3 survival.ConclusionsThese data failed to demonstrate better transplantation outcomes in adult patients receiving double CBT in comparison to those receiving single CBT with adequate TNC after RIC.

Keywords : Transplantation AML ALL Reduced-intensity Unrelated cord blood UCB Single Double

Autor: Frédéric Baron - Annalisa Ruggeri - Eric Beohou - Myriam Labopin - Mohamad Mohty - Didier Blaise - Jan Cornelissen - Patrice Ch



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