Pre-transplant prognostic factors for patients with high-risk leukemia undergoing an unrelated cord blood transplantation

A. P. Iori, R. Cerretti, L. De Felice, M. Screnci, A. Mengarelli, A. Romano, M. Caniglia, L. Cerilli, G. Gentile, M. L. Moleti, F. Giona, F. Agostini, I. Pasqua, M. P. Perrone, M. R. Pinto, L. Grapulin, A. M. Testi, P. Martino, G. De Rossi, F. MandelliWilliam Arcese

Research output: Contribution to journalArticle

Abstract

From July 1995 to December 2001, 42 patients with leukemia aged 1-42 years underwent cord blood transplant (CBT) from unrelated, ≤2 antigen HLA mismatched donors. In all, 26 patients were in ≤ 2nd complete remission and 16 in more advanced phase. Conditioning regimens, graft-versus-host disease (GVHD) prophylaxis and supportive policy were uniform for all patients. The cumulative incidence of engraftment was 90% (95% CI: 0.78-0.91). The cumulative incidence of III-IV grade acute- and chronic-GVHD was 9% (95% CI: 0.04-0.24) and 35% (95% CI: 0.21-0.60), respectively. The 4-year cumulative incidence of transplant-related mortality (TRM) and relapse was 28% (95% CI: 0.17-0.47) and 25% (95% CI: 0.14-0.45), respectively. The 4-year overall survival (OS), leukemia-free survival (LFS) and event-free survival (EFS) were 45% (95% CI: 0.27-0.63), 47% (95% CI: 0.30-0.64) and 46% (95% CI: 0.30-0.62), respectively. In multivariate analysis, the most important factor affecting outcomes was the CFU-GM dose, associated with CMV serology (P=0.003 and 0.04, respectively) in influencing OS and with patient sex (P=0.008 and 0.03, respectively) in influencing LFS. Finally, CFU-GM dose was the only factor that affected EFS significantly (P=0.02). In conclusion, the infused cell dose expressed as in vitro progenitor cell growth is highly predictive of outcomes after an unrelated CBT and should be considered the main parameter in selecting cord blood units for transplant.

Original languageEnglish
Pages (from-to)1097-1105
Number of pages9
JournalBone Marrow Transplantation
Volume33
Issue number11
DOIs
Publication statusPublished - Jun 1 2004

Keywords

  • Cord blood transplant
  • Leukemia
  • Prognostic factors
  • Unrelated HSC transplant

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Iori, A. P., Cerretti, R., De Felice, L., Screnci, M., Mengarelli, A., Romano, A., Caniglia, M., Cerilli, L., Gentile, G., Moleti, M. L., Giona, F., Agostini, F., Pasqua, I., Perrone, M. P., Pinto, M. R., Grapulin, L., Testi, A. M., Martino, P., De Rossi, G., ... Arcese, W. (2004). Pre-transplant prognostic factors for patients with high-risk leukemia undergoing an unrelated cord blood transplantation. Bone Marrow Transplantation, 33(11), 1097-1105. https://doi.org/10.1038/sj.bmt.1704500