Unrelated cord blood transplantation for patients with primary or secondary myelofibrosis.

Abstract

To determine whether umbilical cord blood transplantation (UCBT) is an alternative cure for myelofibrosis (MF), we evaluated 35 UCBTs reported to Eurocord. Seven patients had secondary acute myeloid leukemia (AML) at UCBT, and median age at UCBT was 54 years. Twenty-four patients received a reduced-intensity conditioning (RIC) regimen, and 17 of 35 patients received total body irradiation (2 to 12 Gy)-fludarabine-cyclophosphamide (TCF) conditioning. The median follow-up was 24 months. The cumulative incidence of neutrophil recovery at 60 days was 80%. Fifteen patients relapsed after UCBT. The 2-year overall survival and event-free-survival (EFS) rates were 44% and 30%, respectively. All patients given TCF achieved neutrophil and platelet recovery, and the use of TCF was associated with superior EFS in the RIC population (44% versus 0%, P = .001). Patients with transformation to AML had similar outcomes to patients with less advanced stages. In conclusion, despite graft failure remaining a major concern, the role of UCBT in the management of MF, especially using RIC TCF-based regimens, deserves further investigation to improve results.

• Authors: Marie Robin, Federica Giannotti, Eric Deconinck, Mohamad Mohty, Mauricette Michallet, Guillermo Sanz, Patrice Chevallier, Jean-Yves Cahn, Faezeh Legrand, Montserrat Rovira, Jakob Passweg, Jorge Sierra, Stephanie Nguyen, Natacha Maillard, Ibrahim Yakoub-Agha, Werner Linkesch, Paul Cannell, Magda Marcatti, Jacques-Olivier Bay, Yves Chalandon, Nicolaus Kröger, Eliane Gluckman, Vanderson Rocha, Eduardo Olavarria, Annalisa Ruggeri, Eurocord and Chronic Malignancies Working Party-European Group for Blood and Marrow Transplantation (CMWP-EBMT)
• Journal: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 20 Issue 11 Pg. 1841-6 (Nov 2014) ISSN: 1523-6536 [Electronic] United States
• PMID: 24946719 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Topics

• Cord Blood Stem Cell Transplantation (adverse effects, methods)
• Female
• Fetal Blood
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Male
• Middle Aged
• Primary Myelofibrosis (therapy)
• Transplantation Conditioning (methods)
• Treatment Outcome
• Unrelated Donors