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Cord Blood Stem Cell

Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies

Bone Marrow Transplantation volume 38, pages 421–426 (2006)Cite this article

Abstract

Cell dose is a critical determinant of outcomes in unrelated cord blood (CB) transplantation. We investigated a strategy in which CB units should contain at least 2 × 107 total nucleated cells/kg of recipient weight, otherwise a second unit had to be added. We report the results of a study that was prematurely closed owing to toxicity. Patients with advanced hematologic malignancies without a human leukocyte antigen-matched sibling or unrelated donor were eligible. Conditioning regimen consisted of fludarabine and 12 Gy of total body irradiation (n=11), or melphalan (n=4), with antithymocyte globulin. Graft-versus-host disease prophylaxis was tacrolimus and methotrexate. Fifteen patients with acute leukemia (n=9), chronic myelogenous leukemia (n=2), multiple myeloma (n=2) and lymphoma (n=2) were treated; 60% had relapsed disease at transplantation. Three patients received double CB transplants. The 100-day and 1-year treatment-related mortality rates were 40 and 53%, respectively. Median time to neutrophil and platelet engraftment was 22 days (n=10) and 37 days (n=10), respectively. One patient had secondary graft failure and five patients failed to engraft. Two patients are alive and disease free; 4-year actuarial survival is 33 versus 0% for patients transplanted in remission versus in relapse. We concluded that disease status was the main determinant of treatment failure in this study.

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Authors and Affiliations

  1. Department of Blood and Marrow transplantation, UT MD Anderson Cancer Center, Houston, TX, USA

    L Lekakis, S Giralt, D Couriel, E J Shpall, C Hosing, I F Khouri, P Anderlini, M Korbling, R E Champlin & M de Lima

  2. Division of Hematology and Oncology, Bone Marrow Transplantation, University of California at San Francisco, San Francisco, CA, USA

    T Martin

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  1. L Lekakis
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  2. S Giralt
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  3. D Couriel
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  4. E J Shpall
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  5. C Hosing
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  6. I F Khouri
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  7. P Anderlini
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  8. M Korbling
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  9. T Martin
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  10. R E Champlin
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  11. M de Lima
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Correspondence to M de Lima.

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Lekakis, L., Giralt, S., Couriel, D. et al. Phase II study of unrelated cord blood transplantation for adults with high-risk hematologic malignancies. Bone Marrow Transplant 38, 421–426 (2006). https://doi.org/10.1038/sj.bmt.1705467

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  • DOI: https://doi.org/10.1038/sj.bmt.1705467

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