6533b7defe1ef96bd1275c8f

RESEARCH PRODUCT

Umbilical cord blood transplantation in adults with advanced hodgkin's disease: high incidence of post-transplant lymphoproliferative disease

Jorge GayosoRodrigo MartinoJorge SierraJosé Luis PiñanaPau MontesinosGuillermo SanzCarlos SolanoPere BarbaAlbert EsquirolAlessandra PicardiWilliam ArceseGeth Gitmo GroupsRocío ParodyJaime SanzMiguel A. SanzFederico MoscardóStefano GuidiMaría José Terol

subject

MaleHerpesvirus 4 HumanTransplantation Conditioningmedicine.medical_treatmentGraft vs Host DiseaseHematopoietic stem cell transplantationGastroenterology0302 clinical medicineRecurrencehemic and lymphatic diseasesCumulative incidenceHodgkin's lymphomaIncidence (epidemiology)Graft Survivalumbilical cord blood transplantationHematologyGeneral MedicineMiddle AgedHodgkin DiseaseFludarabine030220 oncology & carcinogenesisAcute DiseaseFemaleCord Blood Stem Cell TransplantationVidarabinemedicine.drugAdultmedicine.medical_specialtyCyclophosphamideThioTEPA03 medical and health sciencesInternal medicinemedicineHumansInfectious MononucleosisBusulfanCyclophosphamideAntilymphocyte Serumbusiness.industryMyeloablative AgonistsHodgkin's lymphomamedicine.diseaseSurvival AnalysisSurgeryEBV post-transplant lymphoproliferative diseaseChronic DiseaseEBV post-transplant lymphoproliferative disease; Hodgkin's disease; Hodgkin's lymphoma; umbilical cord blood transplantationHodgkin's diseasebusinessSettore MED/15 - Malattie del SangueThiotepaBusulfan030215 immunology

description

We report the outcome of 30 consecutive patients with Hodgkin disease (HD) who underwent single-unit UCBT. Most (90%) patients had failed previous autologous hematopoietic stem cell transplantation. The conditioning regimens were based on combinations of thiotepa, busulfan, cyclophosphamide or fludarabine, and antithymocyte globulin. The cumulative incidence (CI) of myeloid engraftment was 90% [95% confidence interval (C.I.), 74-98%] with a median of 18 d (range, 10-48). CI of acute graft-versus-host disease (GvHD) grades II-IV was 30% (95% C.I., 17-44%), while the incidence of chronic GVHD was 42% (95% C.I., 23-77%). The non-relapse mortality (NRM) at 100 d and 4 yr was 30% (95% C.I., 13-46%) and 47% (95% C.I., 29-65%), respectively. EBV-related post-transplant lymphoproliferative disease (EBV-PTLD) accounted for more than one-third of transplant-related death, with an estimate incidence of 26% (95% C.I., 9-44). The incidence of relapse at 4 yr was 25% (95% C.I., 9-42%). Four-year event-free survival (EFS) and overall survival (OS) were 28% and 30%, respectively. Despite a high NRM and an unexpected high incidence of EBV-PTLD, UCBT in heavily pretreated HD patients is an option for patients lacking a suitable adult donor, provided the disease is not in refractory relapse.

yearjournalcountryeditionlanguage
2016-01-01European Journal of Haematology
https://doi.org/10.1111/ejh.12557