|Long-term outcomes in adults with leukemia treated with transplantation of two unrelated umbilical cord blood units|
|Yin Yue; Ren Han-yun; Cen Xin-an; Qiu Zhi-xiang; Ou Jin-ping; Wang Wen-sheng; Wang Mang-ju; Xu Wei-lin; Wang Li-hong; Li Yuan; Dong Yu-jun|
|关键词||Double-unit Umbilical Cord Blood Transplantation Unrelated Donor Leukemia|
|刊名||CHINESE MEDICAL JOURNAL|
|WOS标题词||Science & Technology|
|类目[WOS]||Medicine, General & Internal|
|研究领域[WOS]||General & Internal Medicine|
|关键词[WOS]||ACUTE LYMPHOBLASTIC-LEUKEMIA ; BONE-MARROW ; HEMATOLOGICAL MALIGNANCIES ; QUANTITATIVE-DETERMINATION ; HOST DISEASE ; FOLLOW-UP ; CHILDREN ; ENGRAFTMENT ; DONORS ; RECIPIENTS|
Background Wide application of umbilical cord blood transplantation (UCBT) in adult patients is limited by low cell-dose available in one umbilical cord blood (UCB) unit. The aim of this study was to investigate the safety and long-term outcomes of UCBT from unrelated donors in adult and adolescent patients with leukemia.
Methods Thirteen patients with leukemia received double-unit UCBT with human leukocyte antigen (HLA) mismatched at 0-2 loci. We analyzed the engraftment, graft-versus-host disease (GVHD) and survival. Results Twelve evaluable patients (92.3%) had neutrophil and platelet engraftment at a median of 21 days (range, 16-38 days) and 34 days (range, 25-51 days), respectively. At day 30, engraftment was derived from one donor in 8 patients (66.7%, 95% Cl 40.0%-93.4%), and from both donors in 4 patients (33.3%, 95% Cl 6.7%-60.0%) with 1 unit predominated. Unit with larger nucleated cell (NC) dose would predominate in engraftment (P=0.039), whereas CD34(+) cell dose or HLA-match failed to demonstrate any relationship with unit predominance. Only one patient developed grade II acute graft-versus-host disease (aGVHD). Chronic GVHD (cGVHD) was observed in 2 of 11 patients who survived more than 100 days, and both were limited. The median follow-up after transplantation for the 13 patients was 45 months (range 1.5-121.0 months) and 72 months (range 41.0-121.0 months) for the 8 alive and with full donor chimerism. The 5-year cumulative disease free survival (DFS) was (61.5 +/- 13.5)%. Of the 13 patients, 5 patients died in 1 year and 1-year transplantation related mortality (TRM) was 23.1% (95% Cl 0.2%-46.0%).
Conclusion Double-unit UCBT from unrelated donors with HLA-mismatched at 0-2 loci may overcome the cell-dose barrier and be feasible for adults and adolescents with leukemia. Chin Med J 2011;124(16):2411-2416
|作者单位||Peking Univ, Hosp 1, Dept Hematol, Beijing 100034, Peoples R China|
|Yin Yue,Ren Han-yun,Cen Xin-an,et al. Long-term outcomes in adults with leukemia treated with transplantation of two unrelated umbilical cord blood units[J]. CHINESE MEDICAL JOURNAL,2011,124(16):2411-2416.|
|APA||Yin Yue.,Ren Han-yun.,Cen Xin-an.,Qiu Zhi-xiang.,Ou Jin-ping.,...&Dong Yu-jun.(2011).Long-term outcomes in adults with leukemia treated with transplantation of two unrelated umbilical cord blood units.CHINESE MEDICAL JOURNAL,124(16),2411-2416.|
|MLA||Yin Yue,et al."Long-term outcomes in adults with leukemia treated with transplantation of two unrelated umbilical cord blood units".CHINESE MEDICAL JOURNAL 124.16(2011):2411-2416.|