Long-term follow-up and factors influencing outcomes after related HLA-identical cord blood transplantation for patients with malignancies: An analysis on behalf of Eurocord-EBMT

Andrée Laure Herr, Nabil Kabbara, Carmem M S Bonfim, Pierre Teira, Franco Locatelli, Karin Tiedemann, Arjan Lankester, Jean Pierre Jouet, Chiara Messina, Yves Bertrand, Cristina Díaz De Heredia, Christina Peters, Wagnara Chaves, Samir K. Nabhan, Irina Ionescu, Eliane Gluckman, Vanderson Rocha

Research output: Contribution to journalArticle

Abstract

We analyzed risk factors influencing outcomes after related (R) human leukocyte antigen-identical cord blood transplantation (CBT) for 147 patients with malignancies reported to Eurocord-European Group for Blood and Marrow Transplantation. CBT has been performed since 1990; median follow-up was 6.7 years. Median patient age was 5 years. Acute leukemia was the most frequent diagnosis (74%). At CBT, 40 patients had early, 70 intermediate, and 37 advanced disease. CB grafts contained a median of 4.1 × 107/kg total nucleated cells (TNCs) after thawing. The cumulative incidence (CI) of neutrophil recovery was 90% at day +60. CIs of acute and chronic graft-versus-host disease (GVHD) were 12% and 10% at 2 years, respectively. At 5 years, CIs of nonrelapse mortality and relapse were 9% and 47%, respectively; the probability of disease-free survival (DFS) and overall survival were 44% and 55%, respectively. Among other factors, higher TNCs infused was associated with rapid neutrophil recovery and improved DFS. The use of methotrexate as GVHD prophylaxis decreased the CI of engraftment. Patients without advanced disease had improved DFS. These results support banking and use of CB units for RCBT. Cell dose, GVHD prophylaxis not including methotrexate, and disease status are important factors for outcomes after RCBT.

Original languageEnglish
Pages (from-to)1849-1856
Number of pages8
JournalBlood
Volume116
Issue number11
DOIs
Publication statusPublished - Sep 16 2010

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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    Herr, A. L., Kabbara, N., Bonfim, C. M. S., Teira, P., Locatelli, F., Tiedemann, K., Lankester, A., Jouet, J. P., Messina, C., Bertrand, Y., De Heredia, C. D., Peters, C., Chaves, W., Nabhan, S. K., Ionescu, I., Gluckman, E., & Rocha, V. (2010). Long-term follow-up and factors influencing outcomes after related HLA-identical cord blood transplantation for patients with malignancies: An analysis on behalf of Eurocord-EBMT. Blood, 116(11), 1849-1856. https://doi.org/10.1182/blood-2010-02-271692