Concurrent search for unrelated cord and volunteer donor in high-risk acute lymphoblastic leukemia.
Ann Hematol
; 91(6): 941-8, 2012 Jun.
Article
em En
| MEDLINE
| ID: mdl-22209945
ABSTRACT
To assess the effectiveness of the search for an unrelated donor on the outcome of patients with high-risk acute lymphoblastic leukemia, we analyzed prospectively 136 patients who underwent a search for cord blood (CB) and an unrelated volunteer donor (UD) at the same time. The probability of finding a donor was 58.2%, 70.3%, and 75.7% at 3, 6, and 12 months, respectively. The median time to find a donor was 1.8 months for CB and 3.5 months for UD. Of the 99 patients with a donor, 38.4% failed to undergo the transplant because of a relapse observed at a median of 4 months from the start of the search. In univariate analysis, absence of relapse during the search (p < 0.0001) and transplant (p = 0.004) showed a positive impact on long-term survival. In multivariate analysis, relapse during the search remained the key factor affecting survival (p < 0.0001). Since an extension of the search beyond 3 months enables only a slight increase in the probability of finding a donor compared to the increased risk of relapse, the time of the search should not exceed the 3-month time point. The simultaneous search for CB and UD increases the likelihood of performing a timely transplant.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doadores de Sangue
/
Teste de Histocompatibilidade
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Leucemia-Linfoma Linfoblástico de Células Precursoras
/
Doadores não Relacionados
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
/
Female
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Humans
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Infant
/
Male
/
Middle aged
Idioma:
En
Revista:
Ann Hematol
Assunto da revista:
HEMATOLOGIA
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Itália