Standardized, unrelated donor cord blood transplantation in adults with hematologic malignancies

DOI PDF 10 Citations
  • Guillermo F. Sanz
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Silvana Saavedra
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Dolores Planelles
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Leonor Senent
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Jose Cervera
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Eva Barragán
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Carmen Jiménez
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Luis Larrea
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Guillermo Martı́n
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Jesús Martı́nez
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Isidro Jarque
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Federico Moscardó
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Gemma Plumé
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Rafael Andreu
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Ana I. Regadera
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Inmaculada Garcı́a
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Susana Mollá
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Pilar Solves
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Javier de la Rubia
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Pascual Bolufer
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Luis Benlloch
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Marı́a A. Soler
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Marı́a L. Marty
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.
  • Miguel A. Sanz
    From the Bone Marrow Transplantation Unit, Department of Hematology, and Laboratory of Molecular Biology, Department of Clinical Pathology, Hospital Universitario La Fe; and Centro de Trasfusión de la Comunidad Valenciana; both of Valencia, Spain.

Abstract

<jats:title>Abstract</jats:title> <jats:p>The potential role of unrelated donor cord blood transplantation (UD-CBT) in adults remains unclear. This study reports the results of UD-CBT in 22 adults with hematologic malignancies following conditioning with thiotepa, busulfan, cyclophosphamide, and antithymocyte globulin in 21, with thiotepa, fludarabine, and antithymocyte globulin in 1, and graft-versus-host disease (GVHD) prophylaxis with cyclosporine and prednisone. Median age was 29 years (range, 18-46 years), and median weight was 69.5 kg (range, 41-85 kg). HLA match was 6 of 6 in 1 case, 5 of 6 in 13 cases, and 4 of 6 in 8 cases. Median number of nucleated cells infused was 1.71 × 107/kg (range, 1.01 × 107/kg to 4.96 × 107/kg). All 20 patients surviving more than 30 days had myeloid engraftment, and only 1, who received the lowest cell dose, developed secondary graft failure. Median time to reach an absolute neutrophil count of at least 0.5 × 109/L was 22 days (range, 13-52 days). Median time to platelets numbered at least 20 × 109/L was 69 days (range, 49-153 days). Seven patients (32%) developed acute GVHD above grade II, and 9 of 10 patients at risk developed chronic GVHD, which became extensive in 4 patients. Twelve patients remained alive and disease-free 3 to 45 months after transplantation. Disease-free survival (DFS) at 1 year was 53%. Age strongly influenced DFS (P = .01). For patients aged 30 years or younger, the DFS at 1 year was 73%. These preliminary results suggest that UD-CBT should be considered a reasonable alternative in young adults with hematologic malignancy and no appropriate bone marrow donor.</jats:p>

Journal

  • Blood

    Blood 98 (8), 2332-2338, 2001-10-15

    American Society of Hematology

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