6533b852fe1ef96bd12aa47d

RESEARCH PRODUCT

Umbilical cord blood transplantation from unrelated donors in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia

Pau MontesinosJosé Luis PiñanaGuillermo SanzWilliam ArceseChristelle FerraJaime SanzAlessandra PicardiJ M RiberaPere BarbaRodrigo MartinoMarta González-vicentCarmen MartínAmparo VerdeguerMaría Jesús PascualCristina Díaz De HerediaMiguel A. Sanz

subject

MaleTransplantation Conditioning:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings]Leucemia-linfoma linfoblástico de células precursorasGraft vs Host Disease:Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings]Supervivencia sin EnfermedadGastroenterology:Anatomy::Body Regions::Transplants::Allografts [Medical Subject Headings]:Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents::Myeloablative Agonists [Medical Subject Headings]:Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]hemic and lymphatic diseasesMedicineCumulative incidenceTasa de SupervivenciaPhiladelphia ChromosomeChildCromosoma Filadelfia:Diseases::Pathological Conditions Signs and Symptoms::Pathologic Processes::Disease Attributes::Chronic Disease [Medical Subject Headings]:Named Groups::Persons::Age Groups::Child::Child Preschool [Medical Subject Headings]ArticlesHematologyMiddle AgedPrecursor Cell Lymphoblastic Leukemia-LymphomaAllografts:Analytical Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunosuppression::Transplantation Conditioning [Medical Subject Headings]FludarabineSurvival RateChild Preschool:Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings]:Diseases::Pathological Conditions Signs and Symptoms::Pathologic Processes::Chromosome Aberrations::Translocation Genetic::Philadelphia Chromosome [Medical Subject Headings]:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Survival Analysis::Disease-Free Survival [Medical Subject Headings]FemaleAcondicionamiento para el trasplanteCord Blood Stem Cell TransplantationTrasplante de células madre de la sangre del cordónmedicine.drugAloinjertosAdultmedicine.medical_specialtyAdolescent:Check Tags::Male [Medical Subject Headings]Cord Blood Stem Cell TransplantationPhiladelphia chromosomeEnfermedad injerto contra huéspedDisease-Free SurvivalEstudios retrospectivosInternal medicine:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings]:Named Groups::Persons::Age Groups::Adult [Medical Subject Headings]HumansPreschoolSurvival rate:Named Groups::Persons::Age Groups::Child [Medical Subject Headings]Retrospective Studies:Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Survival Rate [Medical Subject Headings]business.industryUmbilical Cord Blood TransplantationEnfermedad crónicaAgonistas mieloablativosMyeloablative Agonistsmedicine.diseaseSettore MED/15SurgeryTransplantation:Diseases::Immune System Diseases::Graft vs Host Disease [Medical Subject Headings]:Diseases::Hemic and Lymphatic Diseases::Lymphatic Diseases::Lymphoproliferative Disorders::Leukemia Lymphoid::Precursor Cell Lymphoblastic Leukemia-Lymphoma [Medical Subject Headings]:Check Tags::Female [Medical Subject Headings]Estudios de SeguimientoChronic Disease:Analytical Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures Operative::Transplantation::Cell Transplantation::Stem Cell Transplantation::Cord Blood Stem Cell Transplantation [Medical Subject Headings]Adolescent; Adult; Allografts; Child; Child Preschool; Chronic Disease; Disease-Free Survival; Female; Follow-Up Studies; Graft vs Host Disease; Humans; Male; Middle Aged; Myeloablative Agonists; Retrospective Studies; Survival Rate; Cord Blood Stem Cell Transplantation; Philadelphia Chromosome; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Transplantation ConditioningbusinessBusulfanFollow-Up Studies

description

Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; There are very few disease-specific studies focusing on outcomes of umbilical cord blood transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. We report the outcome of 45 patients with Philadelphia chromosome-positive acute lymphoblastic leukemia who underwent myeloablative single unit cord blood transplantation from unrelated donors within the GETH/GITMO cooperative group. Conditioning regimens were based on combinations of thiotepa, busulfan, cyclophospamide or fludarabine, and antithymocyte globulin. At the time of transplantation, 35 patients (78%) were in first complete remission, four (8%) in second complete remission and six (14%) in third or subsequent response. The cumulative incidence of myeloid engraftment was 96% at a median time of 20 days and significantly better for patients receiving higher doses of CD34(+) cells. The incidence of acute grade II-IV graft-versus-host disease was 31%, while that of overall chronic graft-versus-host disease was 53%. Treatment-related mortality was 17% at day +100 and 31% at 5 years. The 5-year relapse, event-free survival and overall survival rates were 31%, 36% and 44%, respectively. Although the event-free and overall survival rates in patients without BCR/ABL transcripts detectable at time of transplant were better than those in whom BCR/ABL transcripts were detected (46% versus 24% and 60% versus 30%, respectively) these differences were not statistically significant in the univariate analysis (P=0.07). These results demonstrate that umbilical cord blood transplantation from unrelated donors can be a curative treatment for a substantial number of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Yes

yearjournalcountryeditionlanguage
2014-02-01
10.3324/haematol.2013.091009http://hdl.handle.net/2108/248297