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Cord Blood Stem Cells

Unrelated donor cord blood transplantation in adults with chronic myelogenous leukemia: results in nine patients from a single institution

Bone Marrow Transplantation volume 27, pages 693–701 (2001)Cite this article

Abstract

The potential role of unrelated donor cord blood transplantation (UD-CBT) in adults is not well established. We report the results of UD-CBT in nine adult patients with chronic myeloid leukemia (CML). The median age was 27 years (range, 19–41 years), and the median weight was 62 kg (range, 45–78 kg). At transplant, six patients were in chronic phase (five in first, and one in second), two in blast crisis, and one in accelerated phase. Eight had received intensive chemotherapy, and three had undergone autologous peripheral blood hematopoietic stem cell transplantation. Four had received interferon with no cytogenetic response, and only three underwent UD-CBT within 1 year of diagnosis. After serological typing for class I antigens, and high-resolution DNA typing for DRB1, the degree of HLA match between patients and cord blood (CB) units was 4/6 in six cases and 5/6 in three cases. The median number of nucleated cells infused was 1.7 × 107/kg (range, 1.2 to 4.9 × 107/kg), and was above 2 × 107/kg in only two cases. All patients received thiotepa, busulfan, cyclophosphamide and anti-thymocyte globulin as conditioning; cyclosporine and prednisone for graft-versus-host disease (GVHD) prophylaxis; and G-CSF from day +7 until engraftment. All seven evaluable cases engrafted. The median time to reach an absolute neutrophil count ⩾0.5 × 109/l and ⩾1 × 109/l was 22 days (range, 19–52 days) and 28 days (range, 23–64 days), respectively. In the four patients evaluable for platelet recovery time to levels of ⩾20 × 109 platelets/l, ⩾50 × 109 platelets/l, and ⩾100 × 109 platelets/l, these ranged from 50 to 128 days, 60 to 139 days, and 105 to 167 days, respectively. Three patients developed acute GVHD above grade II, and three of the five patients at risk developed extensive chronic GVHD. Four patients, all transplanted in chronic phase, remain alive in molecular remission more than 18, 19, 24 and 42 months after transplantation. These preliminary results suggest that UD-CBT may be considered a reasonable alternative in adults with CML who lack an appropriate bone marrow donor. Bone Marrow Transplantation (2001) 27, 693–701.

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References

  1. Chronic Myeloid Leukemia Trialists’ Collaborative Group . Interferon alpha versus chemotherapy for chronic myeloid leukemia: a meta-analysis of seven randomized trials J Natl Cancer Inst 1997 89: 1616–1620

    Article  Google Scholar 

  2. Guilhot F, Chastang C, Michallet M et al. Interferon alfa-2b combined with cytarabine versus interferon alone in chronic myelogenous leukemia. French Chronic Myeloid Leukemia Study Group New Engl J Med 1997 337: 223–229

    Article  CAS  PubMed  Google Scholar 

  3. Kurzrock R, Estrov Z, Kantarjian H, Talpaz M . Conversion of interferon-induced, long-term cytogenetic remissions in chronic myelogenous leukemia to polymerase chain reaction negativity J Clin Oncol 1998 16: 1526–1531

    Article  CAS  PubMed  Google Scholar 

  4. Druker BJ, Talpaz M, Resta D et al. Clinical efficacy and safety of an ABL specific tyrosine kinase inhibitor as targeted therapy for chronic myelogenous leukemia Blood 1999 94: (Suppl. 1) 368a

    Google Scholar 

  5. Druker BJ, Lydon NB . Lessons learned from the development of an ABL tyrosine kinase inhibitor for chronic myeloid leukemia J Clin Invest 2000 105: 3–7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Thomas ED, Clift RA, Fefer A et al. Marrow transplantation for the treatment of chronic myelogenous leukemia Ann Intern Med 1986 104: 155–163

    Article  CAS  PubMed  Google Scholar 

  7. Goldman J, Apperley JF, Jones L et al. Bone marrow transplantation for patients with chronic myeloid leukemia New Engl J Med 1986 314: 202–207

    Article  CAS  PubMed  Google Scholar 

  8. Sawyers CL . Chronic myeloid leukemia New Engl J Med 1999 340: 1330–1340

    Article  CAS  PubMed  Google Scholar 

  9. Faderl S, Talpaz M, Estrov Z, Kantarjian HM . Chronic myelogenous leukemia: biology and therapy Ann Intern Med 1999 131: 207–219

    Article  CAS  PubMed  Google Scholar 

  10. Hansen JA, Gooley TA, Martin PJ et al. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia New Engl J Med 1998 338: 962–968

    Article  CAS  PubMed  Google Scholar 

  11. McGlave PB, Shu XO, Wen W et al. Unrelated donor marrow transplantation for chronic myelogenous leukemia: 9 years’ experience of the National Marrow Donor Program Blood 2000 95: 2219–2225

    CAS  PubMed  Google Scholar 

  12. Kurtzberg J, Laughlin M, Graham MC et al. Placental blood as source of hematopoietic stem cells for transplantation into unrelated recipients New Engl J Med 1996 335: 157–166

    Article  CAS  PubMed  Google Scholar 

  13. Gluckman E, Rocha V, Boyer-Chammard A et al. Outcome of cord blood transplantation from related and unrelated donors. Eurocord Transplant Group and the European Blood and Marrow Transplantation Group New Engl J Med 1997 337: 373–381

    Article  CAS  PubMed  Google Scholar 

  14. Wagner JE, Rosenthal J, Sweetman R et al. Successful transplantation of HLA-matched and HLA-mismatched umbilical cord-blood from unrelated donors: analysis of engraftment and acute graft-versus-host disease Blood 1996 88: 795–802

    CAS  PubMed  Google Scholar 

  15. Cairo MS, Wagner JE . Placental and/or umbilical cord blood: an alternative source of hematopoietic stem cells for transplantation Blood 1997 90: 4665–4678

    CAS  PubMed  Google Scholar 

  16. Rubinstein P, Carrier C, Scaradavou M et al. Outcome among 562 recipients of placental blood transplants from unrelated donors New Engl J Med 1998 339: 1565–1577

    Article  CAS  PubMed  Google Scholar 

  17. Rocha V, Wagner JE, Sobocinski KA et al. Graft-versus-host disease in children who have received a cord blood or bone marrow transplant from an HLA-identical sibling New Engl J Med 2000 342: 1846–1854

    Article  CAS  PubMed  Google Scholar 

  18. Rocha V, Cornish J, Sievers E et al. Comparison of the outcome of unrelated bone marrow (BM) or cord blood (CB) transplants in children with acute leukemia (AL) Blood 1999 94: (Suppl. 1) 712a

    Google Scholar 

  19. Laporte JP, Gorin NC, Rubinstein P et al. Cord-blood transplantation from an unrelated donor in an adult with chronic myelogenous leukemia New Engl J Med 1996 335: 167–170

    Article  CAS  PubMed  Google Scholar 

  20. Pecora AL, Stiff P, Jennis A et al. Prompt and durable engraftment in two older adult patients with high risk chronic myelogenous leukemia (CML) using ex vivo expanded and unmanipulated unrelated umbilical cord blood Bone Marrow Transplant 2000 25: 797–799

    Article  CAS  PubMed  Google Scholar 

  21. Long G, Madan B, Kurtzberg J et al. Unrelated umbilical cord blood transplants in adult patients (PTS) with hematological malignancies or genetic disorders Blood 1999 94: (Suppl. 1) 570a

    Google Scholar 

  22. Terasaki PI, McLelland J . Microdroplet assay of human serum cytoxins Nature 1964 204: 988–1000

    Article  Google Scholar 

  23. Olerup O, Zetterquist H . HLA-DR typing by PCR amplification with sequence-specific primers (PCR-SSP) in 2 hours: an alternative to serological DR typing in clinical practice including donor–recipient matching in cadaveric transplantation Tissue Antigens 1992 39: 225–235

    Article  CAS  PubMed  Google Scholar 

  24. Buyse I, Decorte R, Cuppens H et al. Rapid DNA typing of class II HLA antigens using the polymerase chain reaction and reverse dot blot hybridization Tissue Antigens 1993 41: 1–14

    Article  CAS  PubMed  Google Scholar 

  25. Rubinstein P, Dobrila L, Rosenfield RE et al. Processing and cryopreservation of placental/umbilical cord blood for unrelated bone marrow reconstitution Proc Natl Acad Sci USA 1995 92: 10119–10122

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Miller SA, Dykes DD, Polesky HF . A simple salting out procedure for extracting DNA from human nucleated cells Nucleic Acids Res 1988 16: 1215

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Boerwinkle E, Xiong W, Fourest E, Chan L . Rapid typing of tandemly repeated hypervariable loci by the polymerase chain reaction: application to the apolipoprotein B 3′ hypervariable region Proc Natl Acad Sci USA 1989 86: 212–216

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Budowle B, Chakraborty R, Giusti AM et al. Analysis of the VNTR locus D1S80 by PCR followed by high resolution PAGE Am J Hum Genet 1991 48: 137–144

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Richards B, Heilig R, Oberle I et al. Rapid PCR analysis of the St14 (DXS52) VNTR Nucleic Acids Res 1991 19: 1944

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Chomczynski P, Sacchi N . Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction Anal Biochem 1987 162: 156–159

    Article  CAS  PubMed  Google Scholar 

  31. Cross NC, Hughes TP, Feng L et al. Minimal residual disease after allogenic bone marrow transplantation for chronic myeloid leukemia in first chronic phase: correlations with acute graft-versus-host disease and relapse Br J Haematol 1993 84: 67–74

    Article  CAS  PubMed  Google Scholar 

  32. Gluckman E, Broxmeyer HE, Auerbach AD et al. Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLA-identical sibling New Engl J Med 1989 321: 1174–1178

    Article  CAS  PubMed  Google Scholar 

  33. Wagner JE, Kernan NA, Steinvuch M et al. Allogeneic sibling umbilical-cord-blood transplantation in children with malignant and non-malignant disease Lancet 1995 346: 214–219

    Article  CAS  PubMed  Google Scholar 

  34. Lambertenghi Deliliers G, Soligo D, Della Volpe A et al. Unrelated mismatched cord blood transplantation in an adult with secondary AML Bone Marrow Transplant 1996 18: 469–472

    Google Scholar 

  35. Gonzalez Barca E, Querol S, Grañena A et al. Umbilical cord blood transplantation from an unrelated donor in an adult weighing 90 kilograms. Role of immunosuppression in engraftment Bone Marrow Transplant 1997 20: 333–336

    Article  CAS  PubMed  Google Scholar 

  36. Laughlin MJ, Rizzieri DA, Smith CA et al. Hematologic engraftment and reconstitution of immune function post unrelated placental cord blood transplant in an adult with acute lymphocytic leukemia Leukemia Res 1998 22: 215–219

    Article  CAS  Google Scholar 

  37. Gian VG, Moreb JS, Abdel-Mageed A et al. Successful salvage using mismatched umbilical cord blood transplant in an adult with recurrent acute myelogenous leukemia failing autologous peripheral blood progenitor cell transplant: a case history and review Bone Marrow Transplant 1998 21: 1197–1200

    Article  CAS  PubMed  Google Scholar 

  38. Rocha V, Arcese W, Sanz G et al. Prognostic factors of outcome after unrelated cord blood transplant (UCBT) in adults with hematologic malignancies Blood 2000 96: (Suppl. 1) 587a

    Google Scholar 

  39. Kurtzberg J, Laughlin MJ, Smith CA et al. Hematopoietic recovery in adult recipients following unrelated umbilical cord blood transplantation Blood 1997 90: (Suppl. 1) 480a

    Google Scholar 

  40. Migliaccio AR, Adamson JW, Stevens CE et al. Cell dose and speed of engraftment in placental/umbilical cord blood transplantation: graft progenitor cell content is a better predictor than nucleated cell quantity Blood 2000 96: 2717–2722

    CAS  PubMed  Google Scholar 

  41. Locatelli F, Rocha V, Chastang C et al. Factors associated with outcome after cord blood transplantation in children with acute leukemia. Eurocord Cord Blood Transplant Group Blood 1999 93: 3662–3671

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Hematology, Bone Marrow Transplantation Unit, Hospital Universitario La Fe, Valencia, Spain

    GF Sanz, S Saavedra, C Jiménez, L Senent, J Cervera, G Martín, J Martínez, I Jarque, F Moscardó, G Plumé, R Andreu, J de la Rubia & MA Sanz

  2. Centro de Trasfusión de la Comunidad Valenciana, Valencia, Spain

    D Planelles, L Larrea, P Solves & MA Soler

  3. Department of Clinical Pathology, Laboratory of Molecular Biology, Hospital Universitario La Fe, Valencia, Spain

    P Bolufer & E Barragán

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Sanz, G., Saavedra, S., Jiménez, C. et al. Unrelated donor cord blood transplantation in adults with chronic myelogenous leukemia: results in nine patients from a single institution. Bone Marrow Transplant 27, 693–701 (2001). https://doi.org/10.1038/sj.bmt.1702878

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