Myeloablative Unrelated Cord Blood ...
Document type :
Article dans une revue scientifique: Article original
Permalink :
Title :
Myeloablative Unrelated Cord Blood Transplantation in Adolescents and Young Adults with Acute Leukemia
Author(s) :
Hayashi, Hiromi [Auteur]
Volt, Fernanda [Auteur]
Sanz, Jaime [Auteur]
Petersen, Eefke [Auteur]
Dhédin, Nathalie [Auteur]
Hough, Rachael [Auteur]
Milpied, Noel [Auteur]
Angelucci, Emanuele [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Michallet, Mauricette [Auteur]
Michel, Gerard [Auteur]
Aljurf, Mahmoud [Auteur]
Kenzey, Chantal [Auteur]
Rocha, Vanderson [Auteur]
Dalle, Jean-Hugues [Auteur]
Bader, Peter [Auteur]
Ruggeri, Annalisa [Auteur]
Gluckman, Eliane [Auteur]
Volt, Fernanda [Auteur]
Sanz, Jaime [Auteur]
Petersen, Eefke [Auteur]
Dhédin, Nathalie [Auteur]
Hough, Rachael [Auteur]
Milpied, Noel [Auteur]
Angelucci, Emanuele [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Michallet, Mauricette [Auteur]
Michel, Gerard [Auteur]
Aljurf, Mahmoud [Auteur]
Kenzey, Chantal [Auteur]
Rocha, Vanderson [Auteur]
Dalle, Jean-Hugues [Auteur]
Bader, Peter [Auteur]
Ruggeri, Annalisa [Auteur]
Gluckman, Eliane [Auteur]
Journal title :
Biology of Blood and Marrow Transplantation
Abbreviated title :
Biology of Blood and Marrow Transplantation
Volume number :
25
Pages :
2438-2446
Publication date :
2019-12
ISSN :
10838791
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Outcomes for adolescents and young adults (AYAs) with leukemia differ from other age groups and are still under-represented in clinical research. The aim of this study was to analyze outcomes of umbilical cord blood ...
Show more >Outcomes for adolescents and young adults (AYAs) with leukemia differ from other age groups and are still under-represented in clinical research. The aim of this study was to analyze outcomes of umbilical cord blood transplant (UCBT) in AYAs with acute leukemia reported to Eurocord/European Society for Blood and Marrow Transplantation. Patients (N = 504) had acute lymphoblastic (59%) or myeloid leukemia (41%), were aged 15 to 25 years, and received UCBT after myeloablative conditioning regimens between 2004 and 2016. The primary endpoint was 3-year overall survival (OS). Median follow-up was 3.9 years. Transplant was single in 58% and double UCBT in 42%. Three-year OS was 45% and leukemia free survival (LFS) was 41%. Cumulative incidence functions (CIFs) of nonrelapse mortality (NRM) and relapse were 31% and 28%, respectively. CIF of acute graft-versus-host disease (GVHD) grades II to IV at day 100 was 28%. Three-year CIF of chronic GVHD was 25%. In adjusted analysis, better disease status at UCBT (hazard ratio [HR], 2.74; P < .001) and more recent UCBT (HR, 1.43; P = .01) were associated with increased OS, and a similar effect of these factors was observed on LFS. Contrastingly, the use of antithymocyte globulin had a negative effect in LFS. The risk of acute GVHD grades II to IV increased with the use of double UCBT (HR, 1.65; P = .02) and decreased with more recent transplant period (HR, .65; P = .02) and antithymocyte globulin use (HR, .55; P = .01). Outcomes of AYA UCBT improved in more recent years, becoming comparable with pediatric results. Demonstrating the feasibility of UCBT in AYAs facilitates stem cell source selection and provides the basis for future prospective studies.Show less >
Show more >Outcomes for adolescents and young adults (AYAs) with leukemia differ from other age groups and are still under-represented in clinical research. The aim of this study was to analyze outcomes of umbilical cord blood transplant (UCBT) in AYAs with acute leukemia reported to Eurocord/European Society for Blood and Marrow Transplantation. Patients (N = 504) had acute lymphoblastic (59%) or myeloid leukemia (41%), were aged 15 to 25 years, and received UCBT after myeloablative conditioning regimens between 2004 and 2016. The primary endpoint was 3-year overall survival (OS). Median follow-up was 3.9 years. Transplant was single in 58% and double UCBT in 42%. Three-year OS was 45% and leukemia free survival (LFS) was 41%. Cumulative incidence functions (CIFs) of nonrelapse mortality (NRM) and relapse were 31% and 28%, respectively. CIF of acute graft-versus-host disease (GVHD) grades II to IV at day 100 was 28%. Three-year CIF of chronic GVHD was 25%. In adjusted analysis, better disease status at UCBT (hazard ratio [HR], 2.74; P < .001) and more recent UCBT (HR, 1.43; P = .01) were associated with increased OS, and a similar effect of these factors was observed on LFS. Contrastingly, the use of antithymocyte globulin had a negative effect in LFS. The risk of acute GVHD grades II to IV increased with the use of double UCBT (HR, 1.65; P = .02) and decreased with more recent transplant period (HR, .65; P = .02) and antithymocyte globulin use (HR, .55; P = .01). Outcomes of AYA UCBT improved in more recent years, becoming comparable with pediatric results. Demonstrating the feasibility of UCBT in AYAs facilitates stem cell source selection and provides the basis for future prospective studies.Show less >
Language :
Anglais
Audience :
Non spécifiée
Popular science :
Non
Administrative institution(s) :
CHU Lille
Inserm
Université de Lille
Inserm
Université de Lille
Submission date :
2021-12-08T09:53:04Z
2024-01-30T13:38:31Z
2024-01-30T13:41:02Z
2024-01-30T13:38:31Z
2024-01-30T13:41:02Z