TY - JOUR
T1 - Unrelated cord blood transplantation for childhood acute myeloid leukemia: a Eurocord Group analysis
AU - Michel, Gerard
AU - Rocha, Vanderson
AU - Chevret, Sylvie
AU - Arcese, William
AU - Chan, Kah-Wah
AU - Filipovich, Alexandra
AU - Takahashi, Tsuneo A.
AU - Vowels, Marcus
AU - Ortega, Juan
AU - Bordigoni, Pierre
AU - Shaw, Peter J.
AU - Yaniv, Isaac
AU - Machado, Alexandra
AU - Pimentel, Pedro
AU - Fagioli, Franca
AU - Verdeguer, Amparo
AU - Jouet, Jean Pierre
AU - Diez, Blanca
AU - Ferreira, Euripedes
AU - Pasquini, Ricardo
AU - Rosenthal, Joseph
AU - Sievers, Eric
AU - Messina, Chiara
AU - Iori, Anna Paola
AU - Garnier, Federico
AU - Ionescu, Irina
AU - Locatelli, Franco
AU - Gluckman, Eliane
PY - 2003
Y1 - 2003
N2 - Results of unrelated cord blood transplantation (UCBT) in childhood acute myeloid leukemia (AML) have not been previously reported. We analyzed 95 children receiving UCB transplants for AML (20 in first complete remission [CR1], 47 in CR2, and 28 in more advanced stage). Poor prognosis cytogenetic abnormalities were identified in 29 cases. Most patients received a 1 or 2 HLA antigens-mismatched UCB transplants. The median number of collected nucleated cells (NCs) was 5.2 x 10(7)/ kg. Cumulative incidence (CI) of neutrophil recovery was 78% +/- 4%, acute graft-versus-host disease (GVHD) was 35% +/- 5%, and 100-day transplantation-related mortality (TRM) was 20% +/- 4%. In multivariable analysis, a collected NC dose higher than 5.2 x 10(7)/kg was associated with a lower 100-day TRM. The 2-year Cl of relapse was 29% +/- 5% and was associated with disease status. The 2-year leukemia-free survival (LFS) was 42% +/- 5% (59% +/- 11% in CR1, 50% +/- 8% in CR2, and 21% +/- 9% for children not in CR). Children with poor prognosis cytogenetic features had similar LFS compared with other patients (44% +/- 11% vs 40% +/- 8%). In CR2, LFS was not influenced by the length of CR1 (53% +/- 11% in CR1 < 9.5 months compared with 50% +/- 12% in later relapses). We conclude that UCBT is a therapeutic option for children with very poor-prognosis AML and who lack an HLA-identical sibling. (C) 2003 by The American Society of Hematology.
AB - Results of unrelated cord blood transplantation (UCBT) in childhood acute myeloid leukemia (AML) have not been previously reported. We analyzed 95 children receiving UCB transplants for AML (20 in first complete remission [CR1], 47 in CR2, and 28 in more advanced stage). Poor prognosis cytogenetic abnormalities were identified in 29 cases. Most patients received a 1 or 2 HLA antigens-mismatched UCB transplants. The median number of collected nucleated cells (NCs) was 5.2 x 10(7)/ kg. Cumulative incidence (CI) of neutrophil recovery was 78% +/- 4%, acute graft-versus-host disease (GVHD) was 35% +/- 5%, and 100-day transplantation-related mortality (TRM) was 20% +/- 4%. In multivariable analysis, a collected NC dose higher than 5.2 x 10(7)/kg was associated with a lower 100-day TRM. The 2-year Cl of relapse was 29% +/- 5% and was associated with disease status. The 2-year leukemia-free survival (LFS) was 42% +/- 5% (59% +/- 11% in CR1, 50% +/- 8% in CR2, and 21% +/- 9% for children not in CR). Children with poor prognosis cytogenetic features had similar LFS compared with other patients (44% +/- 11% vs 40% +/- 8%). In CR2, LFS was not influenced by the length of CR1 (53% +/- 11% in CR1 < 9.5 months compared with 50% +/- 12% in later relapses). We conclude that UCBT is a therapeutic option for children with very poor-prognosis AML and who lack an HLA-identical sibling. (C) 2003 by The American Society of Hematology.
KW - N/A
KW - N/A
UR - http://hdl.handle.net/10807/261978
U2 - 10.1182/blood-2003-04-1288
DO - 10.1182/blood-2003-04-1288
M3 - Article
SN - 0006-4971
VL - 102
SP - 4290
EP - 4297
JO - Blood
JF - Blood
ER -