Abstract |
Outcomes after umbilical cord blood transplantation (UCBT) for chronic lymphocytic leukemia (CLL)/ small lymphocytic lymphoma (SLL) are unknown. We analyzed outcomes of 68 patients with poor-risk CLL/SLL who underwent reduced-intensity (RIC) UCBT from 2004 to 2012. The median age was 57 years and median follow-up 36 months; 17 patients had del 17p/p53mutation, 19 patients had fludarabine-refractory disease, 11 relapsed after autologous stem cell transplantation, 8 had diagnosis of prolymphocytic leukemia, 4 had Richter syndrome, and 8 underwent transplantation with progressive or refractory disease. The most common RIC used was cyclophosphamide, fludarabine, and total body irradiation (TBI) in 82%; 15 patients received antithymocyte globulin. Most of the cord blood grafts were HLA mismatched and 76% received a double UCBT. Median total nucleated cells collected was 4.7 × 10(7)/kg. The cumulative incidences (CI) of neutrophil and platelet engraftment were 84% and 72% at 60 and 180 days respectively; day 100 graft-versus-host disease (GVHD) (grade II to IV) was 43% and 3-year chronic GVHD was 32%. The CI of relapse, nonrelapse mortality, overall survival, and progression-free survival (PFS) at 3 years were 16%, 39%, 54%, and 45%, respectively. Fludarabine-sensitive disease at transplantation and use of low-dose TBI regimens were associated with acceptable PFS. In conclusion, use of RIC-UCBT seems to be feasible in patients with poor-risk CLL/SLL and improved outcomes were observed in patients with fludarabine-sensitive disease who received low-dose TBI regimens.
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Authors | Erick Xavier, Jérôme Cornillon, Annalisa Ruggeri, Patrice Chevallier, Jan J Cornelissen, Niels S Andersen, Natacha Maillard, Stephanie Nguyen, Didier Blaise, Eric Deconinck, Hendrik Veelken, Noel Milpied, Michel Van Gelder, Regis Peffault de Latour, Eliane Gluckman, Nicolaus Kröger, Johannes Schetelig, Vanderson Rocha |
Journal | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
(Biol Blood Marrow Transplant)
Vol. 21
Issue 8
Pg. 1515-23
(Aug 2015)
ISSN: 1523-6536 [Electronic] United States |
PMID | 25958294
(Publication Type: Journal Article)
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Copyright | Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Aged
- Cord Blood Stem Cell Transplantation
(adverse effects)
- Disease-Free Survival
- Europe
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell
(therapy)
- Male
- Middle Aged
- Retrospective Studies
- Risk Factors
- Transplantation Conditioning
(adverse effects)
- Treatment Outcome
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