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Prospective study of one- vs two-unit umbilical cord blood transplantation following reduced intensity conditioning in adults with hematological malignancies
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Prospective study of one- vs two-unit umbilical cord blood transplantation following reduced intensity conditioning in adults with hematological malignancies
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Journal Article
Prospective study of one- vs two-unit umbilical cord blood transplantation following reduced intensity conditioning in adults with hematological malignancies
2012
Overview
As the threshold nucleated cell dose for one-unit umbilical cord blood (UCB) in adults has not to date been firmly established, we prospectively compared one- vs two-unit UCB transplantation after reduced intensity conditioning (RIC) in adult patients with hematological malignancies. Study design specified one-UCB unit if the cryopreserved total nucleated cell (TNC) dose was ⩾2.5 × 10
7
/kg recipient weight, otherwise two units matched at minima of 4/6 HLA loci to the patient and 3/6 to each other were infused. A total of 27 patients received one unit; 23 patients received two units. Median time to ANC >500/μL was 24 days (95% confidence interval 22–28 days), 25 days for one unit and 23 days for two units (
P
=0.99). At day 100, ANC >500/μL was 88.4 and 91.3% in the one- and two-unit groups (
P
=0.99), respectively. Three-year EFS was 28.6% and 39.1% in the one- and two-unit groups (
P
=0.71), respectively. Infusion of two units was associated with a significantly lower relapse risk, 30.4% vs 59.3% (
P
=0.045). Infused cell doses (TNC, CD3
+
, CD34
+
and CD56
+
CD3
neg
) did not impact on engraftment, OS or EFS. Taken together, one-unit UCB transplantation with a threshold cell dose ⩾2.5 × 10
7
/kg recipient weight after RIC is a viable option for adults, although infusion of two units confers a lower relapse incidence.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adults
/ Aged
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Biological and medical sciences
/ Blood
/ Bone marrow, stem cells transplantation. Graft versus host reaction
/ Cord Blood Stem Cell Transplantation - adverse effects
/ Cord Blood Stem Cell Transplantation - methods
/ Female
/ Graft vs Host Disease - etiology
/ Hematologic and hematopoietic diseases
/ Hematologic Neoplasms - therapy
/ Histocompatibility antigen HLA
/ Humans
/ Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
/ Male
/ Medicine
/ Transfusions. Complications. Transfusion reactions. Cell and gene therapy
/ Transplantation Conditioning - adverse effects
/ Transplantation Conditioning - methods
/ Weight
