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Acute Leukemia

Risk factors for outcomes after unrelated cord blood transplantation for adults with acute lymphoblastic leukemia: a report on behalf of Eurocord and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation

Bone Marrow Transplantation volume 49, pages 887–894 (2014)Cite this article

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Abstract

We performed a retrospective analysis on 421 adult patients who underwent unrelated cord blood transplantation (UCBT) for ALL. Median age was 32 years; 46% were in first CR (CR1), 32% in CR2 and 22% had advanced disease. Double UCBT was performed in 173 patients (41%). Myeloablative conditioning (MAC) was given to 314 patients (75%). Cumulative incidence (CI) of 60-day neutrophil recovery was 78%. CI of acute and chronic GVHD was 33 and 26%, respectively. Non-relapse mortality (NRM) at 2 years was 42%. Age⩾35 years (P<0.0001), advanced disease at UCBT (P<0.0001) and use of MAC (P<0.0001) were associated with increased NRM. Relapse incidence (RI) at 2 years was 28%; use of reduced intensity conditioning (RIC) (P=0.0002) was associated with increased RI. Two-year leukemia-free survival (LFS) was 39% for patients in CR1, 31% for CR2 and 8% for advanced disease. In multivariate analysis, factors associated with decreased LFS rate were: age ⩾35 years (P=0.034), use of MAC (P=0.032) and advanced disease (P<0.0001). These results show that UCBT is a valuable option to treat high-risk adult ALL when in remission. Strategies to decrease toxicity and relapse are needed to improve final outcomes.

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Acknowledgements

VR is also funded by National Institute for Health Research (NIHR) Biomedical Research Centre funding scheme. We thank Fernanda Volt and Chantal Kenzey for help with data collection.

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Authors and Affiliations

  1.  Eurocord AP-HP, University Paris-Diderot, Saint-Louis Hospital , Paris, France,

    L Tucunduva, A Ruggeri, D Purtill, E Gluckman & V Rocha

  2. Centro de Oncologia, Hospital Sirio Libanes, Sao Paulo, Brazil

    L Tucunduva & V Rocha

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

    A Ruggeri

  4. Servicio de Hematologia, Hospital Universitario La Fe, Valencia, Spain

    G Sanz, J Sanz & P Montesinos

  5. Department of Hematology, Institut Paoli Calmettes, Marseille, France,

    S Furst

  6. Department of Hematology, Bone Marrow Transplantation Unit, Saint-Louis Hospital, Paris, France

    G Socié

  7. Department of Hematology, Edouard Herriot Hospital, Lyon, France

    M Michallet

  8. Division of Hematology, Stem Cell Transplant Unit, University of Rome Tor Vergata, Rome, Italy

    W Arcese

  9. Department of Hematology, CHU Bordeaux, Hôpital Haut-leveque, Pessac, France

    N Milpied

  10. Division of Hematology, CHU de Lille, Lille, France

    I Yakoub-Agha

  11. Division of Hematology, Medical University Graz, Graz, Austria

    W Linkesch

  12. Department of Hematology, Erasmus MC/Daniel Den Hoed, Rotterdam, Netherlands,

    J Cornelissen

  13. Service d'hématologie clinique, Hôpital de l'ARCHET, Nice, France

    L Mannone

  14. Department of Cell Biotechnology and Hematology, University La Sapienza, Rome, Italy

    A P Iori

  15. Department of Hematology, ICO-Hospital Universitari Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Spain

    J-M Ribera

  16. Service d'Hématologie et Thérapie Cellulaire, AP-HP, UPMC Université Paris 6, UMR-S 938, CEREST-TC EBMT, Hôpital Saint Antoine, Paris, France

    M Labopin & M Mohty

  17. Department of Hematology, Churchill Hospital, Oxford University Hospitals, Oxford, UK

    V Rocha

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Correspondence to V Rocha.

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Tucunduva, L., Ruggeri, A., Sanz, G. et al. Risk factors for outcomes after unrelated cord blood transplantation for adults with acute lymphoblastic leukemia: a report on behalf of Eurocord and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 49, 887–894 (2014). https://doi.org/10.1038/bmt.2014.72

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