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Letters to the Editor

Leukemia-free survival in myeloid leukemia, but not in lymphoid leukemia, is predicted by early CD4+ reconstitution following unrelated cord blood transplantation in children: a multicenter retrospective cohort analysis

Bone Marrow Transplantation volume 51, pages 1376–1378 (2016)Cite this article

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Hematopoietic cell transplantation (HCT) is a potentially curative option for chemotherapy-resistant leukemia. In addition to either high-dose chemotherapy or TBI, the advantages of HCT include clearance of residual disease by GvL effect.1 This should lead to a durable CR.

Unrelated umbilical cord blood (CB) has been increasingly used as an alternative cell source during the last decades. However, T-cell immune reconstitution (IR) in CB can be delayed when compared with matched unrelated donors or sibling transplants,2 which may be caused by the lower number of infused T cells combined with a potentially higher susceptibility of CB T cells to serotherapy (for example, anti-thymocyte globulin; ATG).3 Sufficient IR has subsequently been related to a reduced relapse incidence, indicating that reduction of in vivo lymphodepletion of the graft is of utmost importance.4 For this reason, some centers decided to remove ATG from the conditioning regimen in malignant indications.5

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Acknowledgements

This study is funded by the Rational Pharmacotherapy Program (ZonMW) grant number 40-41500-98-11044 of the Dutch Organization for Scientific Research (NWO). RA has received a travel grant from Sanofi to cover part of the costs to present the preliminary work at the ASBMT/CIBMTR 2014 tandem meeting. The funders had no role in the study design, data collection, data analysis, data interpretation and the writing of the report. RA and JJB had full access to all of the data and the final responsibility to submit for publication. We would like to thank the medical and nursing staff from the UMCU and GOSH for implementing this study protocol, and the pediatric immunology laboratory in the Leiden University Medical Center for measuring the historical PK samples.

Author contributions

RA and JJB designed and conducted the research, analyzed the data, and wrote the paper, RC and PV designed the research, analyzed the data, and wrote the paper, and CAL, MBB, ABV, PH and JMFS included patients and wrote the paper.

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Author notes

  1. R Admiraal and R Chiesa: These authors contributed equally to this work.

  2. P Veys and J J Boelens: These authors contributed equally to this work.

Authors and Affiliations

  1. Blood and Marrow Transplantation Program, University Medical Center Utrecht, Utrecht, The Netherlands

    R Admiraal, C A Lindemans, M B Bierings, A B Versluijs & J J Boelens

  2. U-DANCE, Lab Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands

    R Admiraal & J J Boelens

  3. Bone Marrow Transplantation Department, Great Ormond Street Hospital, London, UK

    R Chiesa, P Hiwarkar, J M Furtado Silva & P Veys

  4. U-DAIR, Lab Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands

    S Nierkens

Authors
  1. R Admiraal
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  2. R Chiesa
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  3. C A Lindemans
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  9. P Veys
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  10. J J Boelens
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Corresponding author

Correspondence to J J Boelens.

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The authors declare no conflict of interest.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Admiraal, R., Chiesa, R., Lindemans, C. et al. Leukemia-free survival in myeloid leukemia, but not in lymphoid leukemia, is predicted by early CD4+ reconstitution following unrelated cord blood transplantation in children: a multicenter retrospective cohort analysis. Bone Marrow Transplant 51, 1376–1378 (2016). https://doi.org/10.1038/bmt.2016.116

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