Results of unrelated cord blood transplant in fanconi anemia patients: risk factor analysis for engraftment and survival

Eliane Gluckman, Vanderson Rocha, Irina Ionescu, Marc Bierings, Richard E. Harris, John Wagner, Joanne Kurtzberg, Martin A. Champagne, Carmem Bonfim, Marco Bittencourt, Philip Darbyshire, Manuél-Nicolas Fernandez, Franco Locatelli, Ricardo Pasquini

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

We retrospectively analyzed results of unrelated cord blood transplantation (UCBT) in 93 Fanconi anemia (FA) patients. Median age at transplantation was 8.6 years (1-45). The units transplanted were HLA-A, -B, or -DRB1 identical in 12 cases, 1 HLA mismatch in 35 cases, and 2 or 3 HLA differences in 45 cases. The median number of nucleated cells (NC) and CD34(+) cells infused of recipient weight was 4.9 X 107 /kg and 1.9 X 105/kg, respectively. Participating centers selected the preparative regimen of their choice, in 57 patients (61%), it included Fludarabine. Graft-versus-host disease (GVHD) prophylaxis consisted mostly of cyclosporine with prednisone. Cumulative incidence (CI) of neutrophil recovery was 60 +/- 5% at day +60. In multivariate analysis, Fludarabine containing regimen and NC infused >= 4.9 x 107 /kg were associated with higher probability of recovery. CI of grade II-IV acute and of chronic GVHD (aGVHD, cGVHD) was 32% +/- 5% and 16% +/- 4%, respectively. Overall survival (OS) was 40% +/- 5%. In multivariate analysis, factors associated with favorable outcome were use of Fludarabine in the conditioning regimen, number of NC infused >= 4.9 x 10(7)/kg, and negative cytomegalovirus (CMV) serology in the recipient. In conclusion, factors easily modifiable such as donor selection and a Fludarabine-containing regimen can considerably improve survival in FA patients given a UCBT. These data are the basis for designing prospective protocols. (c) 2007 American Society for Blood and Marrow Transplantation
Lingua originaleEnglish
pagine (da-a)1073-1082
Numero di pagine10
RivistaBiology of Blood and Marrow Transplantation
Volume13
DOI
Stato di pubblicazionePubblicato - 2007

Keywords

  • unrelated cord blood transplantation
  • fludarabine
  • Fanconi anemia

Fingerprint

Entra nei temi di ricerca di 'Results of unrelated cord blood transplant in fanconi anemia patients: risk factor analysis for engraftment and survival'. Insieme formano una fingerprint unica.

Cita questo