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Acute Leukemias

Comparison of outcomes after single or double cord blood transplantation in adults with acute leukemia using different types of myeloablative conditioning regimen, a retrospective study on behalf of Eurocord and the Acute Leukemia Working Party of EBMT

Leukemia volume 28, pages 779–786 (2014)Cite this article

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Abstract

We report outcomes after single (s) and double (d) umbilical cord blood transplantation (UCBT) after myeloablative conditioning (MAC) regimen for 239 patients transplanted for acute leukemia in first complete remission (CR1). All sUCBT patients received a total nucleated cell dose >2.5 × 107/kg. Conditioning regimen for sUCBT was total body irradiation (TBI)12 Gy- or busulfan (BU)-based±fludarabine (Flu) (n=68, group 1), thiotepa+BU+Flu (TBF) (n=88, group 2), and for dUCBT it was TBI12 Gy+cyclophosphamide±Flu (n=83, group 3). dUCBT recipients were younger, received higher cell dose and less frequently antithymocyte globulin. In multivariate analysis, we found similar neutrophil recovery among the three groups; however, acute graft-versus-host disease II–IV was higher in dUCBT compared with others. Non-relapse mortality and relapse incidence were not statistically different among the three groups. Leukemia-free survival was 30% for sUCBT using TBI- or BU-based MAC compared with 48% for sUCBT TBF and 48% for dUCBT (P=0.02 and P=0.03, respectively), and it was not statistically different between sUCBT with TBF and dUCBT. In conclusion, use of sUCBT with adequate cell dose (>2.5 × 107/kg) and a specific conditioning regimen in the MAC setting results in similar outcomes as dUCBT. The choice of TBF conditioning regimen for sUCBT may improve results, and whether this regimen may be effective in dUCBT should be further analyzed.

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Acknowledgements

This study was funded in part by the Inserm grant TGIR0805. VR is funded by the National Institute for Health Research (NIHR)-Biomedical Research Centre (BRC) funding scheme. We thank ‘DU formation à la conduit de projet de recherché Clinique’ Université Paris-Diderot-France. We also thank Chantal Kenzey for help with data collection and the following participating centers for contributing to the cases: Australia, Perth, WA—RP Group Royal Perth Hospital; Austria, Graz—Medical University Graz; Austria, Vienna—Medizinische Universitaet Wien; Belgium, Brussels—Universitair Ziekenhuis Brussel; Belgium, Liege—University of Liege; Finland, Helsinki—Helsinki University Central Hospital; France, Angers—CHR Angers; France, Besançon—Saint Jacques; France, Bordeaux—Haut-Lévêque; France, Brest—Augustin Morvan; France, Caen—CHU de Caen; France, Clermont—Ferrand-Hôtel Dieu CHU/Jean Perrin; France, Grenoble—Tronche CHU/Albert Michallon; France, Lille—Claude Huriez; France, Lyon—Edouard Herriot (adulte); France, Marseille—Paoli Calmettes (adulte); France, Montpellier—Lapeyronie (adulte); France, Nancy—Brabois; France, Nantes—Hôtel Dieu; France, Nice—Archet; France, Paris—La Pitié; France, Paris—Saint-Louis; France, Rennes—Pontchaillou; France, Saint-Etienne—Hôpital Nord/Institut de Cancérologie de la Loire; Germany, Düsseldorf—Heinrich Heine Universität; Germany, Düsseldorf—Universitaetsklinikum; Germany, Idar-Oberstein—Klinik Hamatologie/Onkologie; Germany, Munich—Klinikum Grosshadern; Germany, Regensburg—University Regensburg; Greece, Athens—Evangelismos Hospital; Greece, Patras—University Medical School; Hungary, Budapest—St István and St Laszlo Hospital of Budapest; Ireland, Dublin—St James’s Hospital; Israel, Jerusalem—Hadassah University Hospital; Israel, Tel-Hashomer—Chaim Sheba Medical Center; Italy, Bergamo—Ospedali Riuniti di Bergamo; Italy, Bologna—Bologna University, S Orsola-Malpighi Hospital; Italy, Brescia—TMO Adulti Brescia; Italy, Cuneo—Azienda Ospedaliera S Croce e Carle; Italy, Firenze—Azienda Ospedaliero Universitaria Meyer-Ospedale di Careggi; Italy, Monza—Ospedale San Gerardo; Italy, Palermo—Ospedale V Cervello; Italy, Rome—Ospedale S Camillo; Italy, Rome—Rome Transplant Network; Italy, Rome—Universita Cattolica S Cuore; Italy, Siena—Azienda Ospedaliera Universitaria Senese Policlinico S Maria alle Scotte; Italy, Torino—Ospedale Universitaria San Giovanni Battista; Italy, Tricase (Lecce)—Hospital C Panico; Jordan, Amman—King Hussein Cancer Centre; Poland, Warsaw—The Medical University of Warsaw; Portugal, Porto—Inst. Portugues de Oncologia do Porto; Saudi Arabia, Riyadh—King Faisal Specialist Hospital and Research Centre; Spain, Barcelona—Hospital Clinic; Spain, Barcelona—Hospital Santa Creu i Sant Pau; Spain, Barcelona—ICO-Hospital Universitari Germans Trias i Pujol. Jose Carreras Research Institute, Badalona, Spain-ICO-Hospital Duran i Reynals; Spain, Córdoba—Hosp. Reina Sofia; Spain, Granada—Hospital Univ. Virgen de las Nieves; Spain, Madrid—Hospital Gregorio Marañón; Spain, Málaga—Hospital Carlos Haya; Spain, Murcia—Hospital Morales Meseguer; Spain, Oviedo—University Hospital of Asturias; Spain, Salamanca—Hospital Clínico; Spain, Sevilla—Hospital Universitario Virgen del Rocío; Spain, Valencia—Hospital Clínico Universitario; Spain, Valencia—Hospital Universitario La Fe; Sweden, Goeteborg—Sahlgrenska University Hospital; Sweden, Stockholm—Karolinska University Hospital Children’s Hospital; Switzerland, Geneva—Hopitaux Universitaires de Geneve; Switzerland, Zürich—University Hospital; The Netherlands, Leiden—University Hospital; The Netherlands, Rotterdam—Erasmus MC-Daniel den Hoed Cancer Centre; Turkey, Ankara—University Faculty of Medicine; United Kingdom, Birmingham—Birmingham Heartlands Hospital; United Kingdom, Birmingham—Queen Elizabeth Hospital; United Kingdom, Bristol—Royal Hospital for Children; United Kingdom, Glasgow—Gartnaval General Hospital; United Kingdom, Leicester—Leicester Royal Infirmary; United Kingdom, London—Imperial College Hammersmith Hospital; United Kingdom, London—King’s Denmark Hill Campus School of Medicine; United Kingdom, London—Royal Free and University College Medical School; United Kingdom, London—Surrey Royal Marsden Hospital; United Kingdom, Oxford—Churchill Hospital.

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Authors and Affiliations

  1. Eurocord, Hôpital Saint Louis, AP-HP, and IUH University Paris VII, Paris, France

    A Ruggeri, F Volt, S Nabhan, E Gluckman & V Rocha

  2. Rome Transplant Network, University Tor Vergata, Rome, Italy

    A Ruggeri & W Arcese

  3. Hospital Universitario La Fe, Valencia, Spain

    G Sanz & J Sanz

  4. CHU Sainte-Justine, Montreal, QC, Canada

    H Bittencourt

  5. Ospedali Riuniti di Bergamo, Bergamo, Italy

    A Rambaldi

  6. Hôpital Claude Huriez, Lille, France

    I Yakoub-Agha

  7. ICO-Hospital Universitari Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Spain

    J M Ribera

  8. Hôpital l’Archet, Nice, France

    L Mannone

  9. Hospital Santa Creu i Sant Pau, Barcelona, Spain

    J Sierra

  10. Hospital Saint Antoine, Service d’Hématologie et Thérapie Cellulaire, AP-HP, UPMC Univ Paris 06, UMR-S 938, CEREST-TC EBMT, Paris, France

    M Mohty & M Labopin

  11. Hospital Clínico Universitario, Valencia, Spain

    C Solano

  12. Churchill Hospital, Oxford University Hospitals, Oxford, UK

    V Rocha

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  1. A Ruggeri
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on behalf of Eurocord and Acute Leukemia Working Party of European Blood and Marrow Transplant Group

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Correspondence to A Ruggeri.

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AR, HB and VR designed the study; AR, HB and SN prepared and analyzed data; AR, FV, EG and VR wrote the paper; GS, AR2, IYA, JR, LM, JS, MM, CS and WA provided cases for the study; and ML helped to analyze the data. All authors edited and approved the manuscript.

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Ruggeri, A., Sanz, G., Bittencourt, H. et al. Comparison of outcomes after single or double cord blood transplantation in adults with acute leukemia using different types of myeloablative conditioning regimen, a retrospective study on behalf of Eurocord and the Acute Leukemia Working Party of EBMT. Leukemia 28, 779–786 (2014). https://doi.org/10.1038/leu.2013.259

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