Relapse risk after umbilical cord blood transplantation: enhanced graft-versus-leukemia effect in recipients of 2 units.
作者： Michael R. Verneris , Claudio G. Brunstein , Juliet Barker , Margaret L. MacMillan , Todd DeFor
DOI: 10.1182/BLOOD-2009-05-220525
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摘要: Umbilical cord blood (UCB) transplantation is potentially curative for acute leukemia. This analysis was performed to identify risk factors associated with leukemia relapse following myeloablative UCB transplantation. Acute patients (n = 177; 88 lymphoblastic and 89 myeloid leukemia) were treated at a single center. Patients received graft composed of either 1 (47%) or 2 (53%) partially human leukocyte antigen (HLA)-matched unit(s). Conditioning cyclophosphamide total body irradiation without fludarabine. The incidence 26% (95% confidence interval [CI], 19%-33%). In multivariate analysis, higher in advanced disease (> third complete remission [CR3]; relative [RR], 3.6; P < .01), trend toward less recipients units (RR 0.6; .07). However, lower CR1-2 who 0.5; .03). Leukemia-free survival 40% CI, 30%-51%) 51% 41%-62%) single- double-unit recipients, respectively (P .35). Although it known that CR1 CR2 risk, this reveals an enhanced graft-versus-leukemia effect after HLA-matched units. trial registered http://clinicaltrials.gov as NCT00309842.
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bloodjournal.org参考文章(39)
MM Horowitz, RP Gale, PM Sondel, JM Goldman, J Kersey, HJ Kolb, AA Rimm, O Ringden, C Rozman, B Speck, Graft-versus-leukemia reactions after bone marrow transplantation Blood. ,vol. 75, pp. 555- 562 ,(1990) , 10.1182/BLOOD.V75.3.555.555
John E. Wagner, Juliet N. Barker, Todd E. DeFor, K. Scott Baker, Bruce R. Blazar, Cindy Eide, Anne Goldman, John Kersey, William Krivit, Margaret L. MacMillan, Paul J. Orchard, Charles Peters, Daniel J. Weisdorf, Norma K. C. Ramsay, Stella M. Davies, Transplantation of unrelated donor umbilical cord blood in 102 patients with malignant and nonmalignant diseases: influence of CD34 cell dose and HLA disparity on treatment-related mortality and survival. Blood. ,vol. 100, pp. 1611- 1618 ,(2002) , 10.1182/BLOOD-2002-01-0294
Przepiorka D, Weisdorf D, Hows J, Beatty P, Martin P, Klingemann Hg, Thomas Ed, 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplantation. ,vol. 15, pp. 825- 828 ,(1995)
Mary J. Laughlin, Mary Eapen, Pablo Rubinstein, John E. Wagner, Mei-Jei Zhang, Richard E. Champlin, Cladd Stevens, Juliet N. Barker, Robert P. Gale, Hillard M. Lazarus, David I. Marks, Jon J. van Rood, Andromachi Scaradavou, Mary M. Horowitz, Outcomes after Transplantation of Cord Blood or Bone Marrow from Unrelated Donors in Adults with Leukemia The New England Journal of Medicine. ,vol. 351, pp. 2265- 2275 ,(2004) , 10.1056/NEJMOA041276
Navneet S. Majhail, Claudio G. Brunstein, John E. Wagner, Double umbilical cord blood transplantation Current Opinion in Immunology. ,vol. 18, pp. 571- 575 ,(2006) , 10.1016/J.COI.2006.07.015
Satoshi Takahashi, Jun Ooi, Akira Tomonari, Takaaki Konuma, Nobuhiro Tsukada, Maki Oiwa-Monna, Kenji Fukuno, Michihiro Uchiyama, Kashiya Takasugi, Tohru Iseki, Arinobu Tojo, Takuhiro Yamaguchi, Shigetaka Asano, Comparative single-institute analysis of cord blood transplantation from unrelated donors with bone marrow or peripheral blood stem-cell transplants from related donors in adult patients with hematologic malignancies after myeloablative conditioning regimen Blood. ,vol. 109, pp. 1322- 1330 ,(2007) , 10.1182/BLOOD-2006-04-020172
E. L. Kaplan, Paul Meier, Nonparametric Estimation from Incomplete Observations Springer Series in Statistics. ,vol. 53, pp. 319- 337 ,(1992) , 10.1007/978-1-4612-4380-9_25
I. McNiece, J. Harrington, J. Turney, J. Kellner, E.J. Shpall, Ex vivo expansion of cord blood mononuclear cells on mesenchymal stem cells Cytotherapy. ,vol. 6, pp. 311- 317 ,(2004) , 10.1080/14653240410004871
P. Rubinstein, L. Dobrila, R. E. Rosenfield, J. W. Adamson, G. Migliaccio, A. R. Migliaccio, P. E. Taylor, C. E. Stevens, Processing and cryopreservation of placental/umbilical cord blood for unrelated bone marrow reconstitution. Proceedings of the National Academy of Sciences of the United States of America. ,vol. 92, pp. 10119- 10122 ,(1995) , 10.1073/PNAS.92.22.10119
Celso A Rodrigues, Guillermo Sanz, Claudio G Brunstein, Jaime Sanz, John E Wagner, Marc Renaud, Marcos De Lima, Mitchell S Cairo, Sabine Fürst, Bernard Rio, Christopher Dalley, Enric Carreras, Jean-Luc Harousseau, Mohamad Mohty, Denis Taveira, Peter Dreger, Anna Sureda, Eliane Gluckman, Vanderson Rocha, None, Analysis of Risk Factors for Outcomes After Unrelated Cord Blood Transplantation in Adults With Lymphoid Malignancies: A Study by the Eurocord-Netcord and Lymphoma Working Party of the European Group for Blood and Marrow Transplantation Journal of Clinical Oncology. ,vol. 27, pp. 256- 263 ,(2009) , 10.1200/JCO.2007.15.8865